Individual
LATORIA J BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 CORPORATE DR, OPELIKA, AL 36801-6861
(334) 745-5765
(334) 745-9830
Mailing address
201 MONROE ST, SUITE 1350, MONTGOMERY, AL 36104-3735
(334) 206-5675
(334) 206-3998
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-144026
AL
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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