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LELAND BASS O.D.
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1639219132
Individual Registrant: LELAND BASS O.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
9 W PUTNAM AVE GREENWICH, CT 06830-5327 US
Tel: 203-552-6830 Fax: --
Tel: 203-552-6830 Fax: --
Contact information for business:
9 W PUTNAM AVE GREENWICH, CT 06830-5327 US
Tel: 203-552-6830 Fax: --
Tel: 203-552-6830 Fax: --
Registration Information:
NPI: 1639219132
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | CT | 2384 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
