Organization
ALLEN COUNTY COMMUNITY COLLEGE
Active
Other names
ACCC Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1801 N COTTONWOOD ST, IOLA, KS 66749-1648
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0433232
KS
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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