Provider Demographics
NPI:1992023956
Name:BASS, TANGELA LEE (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:TANGELA
Middle Name:LEE
Last Name:BASS
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BEAR DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4458
Mailing Address - Country:US
Mailing Address - Phone:864-655-4005
Mailing Address - Fax:864-655-4004
Practice Address - Street 1:52 BEAR DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4458
Practice Address - Country:US
Practice Address - Phone:864-655-4005
Practice Address - Fax:864-655-4004
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC288171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist