Individual provider · NPI-1

Charles Edward Bass Jr., RPT

Physical Therapist · Dublin, GA

NPI number1295706117
StatusActive
Last updated in NPPESJun 29, 2023

Details

NPI
1295706117
Entity type
Individual (NPI-1)
Name
Mr. Charles Edward Bass Jr.
Credential
RPT
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 30, 2006
Certification date
Jun 29, 2023
Last updated
Jun 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist1787GAYes

Practice location

101 Fairview Park Dr
Dublin, GA 31021-2501

Phone 478-272-7494 · Fax 478-272-2616

Mailing address

Po Box 883
Dublin, GA 31040-0883

Phone 478-272-7494 · Fax 478-272-2616

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