Individual
JENNIFER K BASS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
112 S 42ND ST, MT VERNON, IL 62864
(618) 244-0508
(618) 244-0646
Mailing address
112 S 42ND ST, MT VERNON, IL 62864
(618) 244-0508
(618) 244-0646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
08/01/2005
Last updated
07/08/2007
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