Individual
JUSTICE KRISTINA-MARIE BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E WILLARD AVE APT 4, LANSING, MI 48910-3078
(269) 213-9724
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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