| NPI | 1336881572 |
|---|---|
| Doing Business As | FLORIDA TECH 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 | 2022-04-08 |
| Last Update Date | 2022-04-08 |