| NPI | 1568950178 |
|---|---|
| Doing Business As | LASALLE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |