| NPI | 1649742255 |
|---|---|
| Doing Business As | SUL ROSS SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2018-12-20 |