Individual
MIRAKA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4051 CEDAR LN STE B, PORTSMOUTH, VA 23703-2003
(757) 975-3906
Mailing address
4051 CEDAR LN STE B, PORTSMOUTH, VA 23703-2003
(757) 975-3906
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
VA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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