Organization
SOUTHERN VIRGINIA UNIVERSITY
Active
Other names
SVU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR/AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1 UNIVERSITY HILL DR, KNIGHT SPORTS ARENA, BUENA VISTA, VA 24416-3038
(540) 261-4931
(540) 266-3866
Mailing address
15305 DALLAS PKWY STE 800, ADDISON, TX 75001-6415
(972) 367-4845
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
12/17/2021
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