Individual
BETTY BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
693 MIGGINS ROAD, CANTON, MS 39046
(601) 506-7177
Mailing address
693 MIGGINS ROAD, CANTON, MS 39046
(601) 506-7177
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
MS
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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