| NPI | 1689231912 |
|---|---|
| Doing Business As | SHENANDOAH SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2021-12-17 |