NPI | 1396404299 |
---|---|
Doing Business As | BASS PRO SHOPS DBA OUTFITTERS HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | JONATHAN LEIZMAN President 216-479-9063 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2021-12-08 |
Last Update Date | 2022-10-13 |