| NPI | 1740637867 |
|---|---|
| Doing Business As | NEW MEXICO JUNIOR COLLEGE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |