Organization
WINSTON-SALEM STATE UNIVERSITY
Active
Other names
WSSU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IAN MUSHINSKI ATC, LAT (HEAD ATHLETIC TRAINER)
(336) 750-2597
Entity
Organization
Contact information
Practice address
1250 S MLK JR DR, WINSTON SALEM, NC 27107-1370
(336) 750-2597
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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