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Organization
WILLIAM PENN UNIVERSITY
Active
Organization
WILLIAM PENN UNIVERSITY
Active
Other names
William Penn Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
201 TRUEBLOOD AVE, OSKALOOSA, IA 52577-1757
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DO-05128
IA
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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