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Individual

ANDREW M BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1601 MAPLE STREET ATHLETIC OPERATIONS BUILDING, CARROLLTON, GA 30118-0001
(678) 839-6628
(678) 839-6546
Mailing address
1601 MAPLE ST, CARROLLTON, GA 30118-0001
(678) 839-6628
(678) 839-6546

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1233
AL

Other

Enumeration date
12/06/2011
Last updated
10/27/2017
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