Organization
FERRUM COLLEGE
Active
Other names
Ferrum College Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(800) 555-9073
Entity
Organization
Contact information
Practice address
590 FERRUM MOUNTAIN RD, HANK NORTON CENTER, FERRUM, VA 24088
(540) 365-4493
(972) 367-3451
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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