| NPI | 1902314156 |
|---|---|
| Doing Business As | WILLIAM PENN SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IA DO-05128) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |