Individual
ALEXANDRIA BASS GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
412 E JOHNSON ST, CLINTON, NC 28328-2806
(910) 490-1240
(910) 490-1260
Mailing address
412 E JOHNSON ST, CLINTON, NC 28328-2806
(910) 490-1240
(910) 490-1260
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
078561
GA
207N00000X
Dermatology Physician
78561
GA
Other
Enumeration date
03/11/2015
Last updated
03/04/2022
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