Individual
BRIAN KIRK WASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5362 LEMEE LN, MARIPOSA, CA 95338-9556
(209) 966-2000
(209) 742-0996
Mailing address
PO BOX 99, MARIPOSA, CA 95338-0099
(209) 742-0854
(209) 742-0996
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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