| NPI | 1689179764 |
|---|---|
| Doing Business As | SEOSU SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MUZON BASS Administrator 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |