Individual
MR. COLE TIMOTHY BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S NATIONAL AVE # PROF160, SPRINGFIELD, MO 65897-0001
(417) 836-8553
(417) 836-8554
Mailing address
203 N BLUEBIRD LN, NIXA, MO 65714-8461
(417) 522-6361
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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