Individual
MRS. STEPHANIE MICHELLE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/R
Contact information
Practice address
2725 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-2346
(573) 778-9348
(573) 686-4870
Mailing address
2725 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-2346
(573) 778-9348
(573) 686-4870
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
117264
MO
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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