Organization
EAST STROUDSBURG UNIVERSITY
Active
Other names
ESU Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS (ADMINISTRATOR)
(972) 367-4845
Entity
Organization
Contact information
Practice address
200 PROSPECT ST, EAST STROUDSBURG, PA 18301-2956
(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
—
—
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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