Individual
DR. ROBERT LEBO BASS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D., F.A.A.O.
Contact information
Practice address
8721 DIGGES RD, MANASSAS, VA 20110-4403
(703) 361-4161
(703) 361-4163
Mailing address
8721 DIGGES RD, MANASSAS, VA 20110-4403
(703) 361-4161
(703) 361-4163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0118000006
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118000006
LICENSE
VA
05
—
9232478
—
VA
Enumeration date
07/08/2005
Last updated
03/07/2023
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