| NPI | 1609596592 | 
|---|---|
| Doing Business As | EWC SPORTS MEDICINE | 
| Entity Type | Organization | 
| Authorized Contact | MOUZON BASS CEO/Administrator 972-367-4845 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine | 
| Enumeration Date | 2022-08-31 | 
| Last Update Date | 2022-08-31 |