Individual provider · NPI-1

Justice Kristina-Marie Bass

Technician, Other · Lansing, MI

NPI number1649890096
StatusActive
Last updated in NPPESApr 24, 2020

Details

NPI
1649890096
Entity type
Individual (NPI-1)
Name
Justice Kristina-Marie Bass
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 24, 2020
Certification date
Apr 24, 2020
Last updated
Apr 24, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other–MIYes

Practice location

401 E Willard Ave Apt 4
Lansing, MI 48910-3078

Phone 269-213-9724

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

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Other Technician, Other providers in Lansing, MI