Individual
KEVIN BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 HILLRIDGE DR, LEESBURG, GA 31763-1146
(229) 869-1134
Mailing address
206 HILLRIDGE DR, LEESBURG, GA 31763-1146
(229) 869-1134
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003388
GA
Other
Enumeration date
04/26/2025
Last updated
04/26/2025
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