| NPI | 1811437890 |
|---|---|
| Doing Business As | TABOR COLLEGE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: KS 04-34857) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2017-02-24 |