| NPI | 1215711155 |
|---|---|
| Doing Business As | AUGUSTA UNIVERSITY ATHLETICS |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-08-22 |