| NPI | 1831848860 |
|---|---|
| Doing Business As | BREVARD COLLEGE ATHLETICS |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-03-18 |