| NPI | 1356713572 |
|---|---|
| Doing Business As | WESTERN NEW ENGLAND UNIVERSITY SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2015-10-27 |