Organization
MID-AMERICA NAZARENE UNIVERSITY
Active
Organization
MID-AMERICA NAZARENE UNIVERSITY
Active
Other names
Mid-America Nazarene University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGEN)
(972) 367-4845
Entity
Organization
Contact information
Practice address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
(972) 367-4845
Mailing address
2030 E COLLEGE WAY, OLATHE, KS 66062-1851
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
04-28344
KS
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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