KELLEY JOHANNA BASS, PA-C

NPI: 1316112295 · Individual · Active

Primary Specialty

Surgical Physician Assistant
Physician Assistant — Surgical

Practice Location

621 S. NEW BALLAS RD.
SUITE 297-A
ST. LOUIS, MO 63141-8200 Map ↗
Phone: 314-251-6364
Fax: 314-251-7897

All Specialties & Licenses

  • Surgical Physician Assistant Primary — Surgical (license: 2008013830, MO)

NPI Registration

Enumerated: 2008-04-23

Last CMS Update: 2008-06-12