Individual
KATIE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 BRIDLEWOOD DR, PLOVER, WI 54467-3892
(715) 342-9100
Mailing address
1540 HIGH ST, WISCONSIN RAPIDS, WI 54495-2467
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1668-19
WI
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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