Organization
BUSHNELL UNIVERSITY
Active
Other names
Northwest Christian University
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
828 E 11TH AVE, EUGENE, OR 97401-3745
(541) 684-7351
(972) 367-3451
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(972) 367-4845
(972) 367-3451
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
—
—
Other
Enumeration date
08/11/2015
Last updated
08/12/2020
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