Individual
KIM BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3409 W WENDOVER AVE STE C, GREENSBORO, NC 27407-1579
(336) 687-2657
Mailing address
3409 W WENDOVER AVE STE C, GREENSBORO, NC 27407-1579
(336) 687-2657
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D2250561
CLIA
—
Enumeration date
01/28/2022
Last updated
01/28/2022
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