Individual
JONATHAN GARRETT BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
126 W GALLATIN ST, HAZLEHURST, MS 39083-3007
(601) 894-5929
(601) 894-2693
Mailing address
126 W GALLATIN ST, P.O. BOX 508, HAZLEHURST, MS 39083-3007
(601) 894-5929
(601) 894-2693
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4913
MS
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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