| NPI | 1427577923 |
|---|---|
| Doing Business As | OKWU SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 3219) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2017-09-15 |