| NPI | 1609224310 |
|---|---|
| Doing Business As | FORT HAYS STATE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0537903) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |