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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

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