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Dr. Paola Reese Bass
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NPI Number Detailed Information
Provider Information:
Name: | Dr. Paola Reese Bass |
Gender: | F |
Provider License Number If Given: | 19201 |
NPI Information:
NPI: | 1821091869 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 5/23/2005 |
Last Update Date: | 4/27/2018 |
Provider Business Mailing Address:
Address: | 210 WESTSIDE DR Dothan, AL 36303 |
Phone Number: | 3347935074 |
Fax Number: | 3347936460 |
Provider Business Practice Location Address:
Address: | 210 WESTSIDE DR Dothan, AL 36303 |
Phone Number: | 3347935074 |
Fax Number: | 3347936460 |
Provider Taxonomy:
Primary: | 207R00000X |
Secondary (if any): | |
State: | AL |