Organization
UNIVERSITY OF MAINE
Active
Other names
University of Maine Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
5747 MEMORIAL GYM, ORONO, ME 04469-5747
(207) 581-1072
Mailing address
PO BOX 650850, DALLAS, TX 75265-0850
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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