| NPI | 1811386220 | 
|---|---|
| Doing Business As | UMT SPORTS MEDICINE | 
| Entity Type | Organization | 
| Authorized Contact | MOUZON BASS Agent 1800-555-9073  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine | 
| Enumeration Date | 2015-01-22 | 
| Last Update Date | 2015-01-22 |