TIMOTHY JAMES BASS

PROVO, UT
NPI1609389311
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: UT  6123836-4810)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TN  1560)
Enumeration Date2017-11-16
Last Update Date2022-06-03
Business Address
Mr. TIMOTHY JAMES BASS ATC, LAT, CES
1143 SFH
PROVO, UT 84602-2246
Phone number: 801-422-0974
Mailing Address
Mr. TIMOTHY JAMES BASS ATC, LAT, CES
1143 SFH
PROVO, UT 84602-2246
Phone number: 805-760-8213
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