| NPI | 1194104224 |
|---|---|
| Doing Business As | WESLYAN SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |