Organization
BUMPS N' BRUISES PEDIATRIC URGENT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA HOLTON (PROVIDER ENROLLMENT COORDINATOR)
(804) 643-2287
Entity
Organization
Contact information
Practice address
2251 MATLOCK RD, MANSFIELD, TX 76063-3825
(330) 495-6359
Mailing address
2251 MATLOCK RD, MANSFIELD, TX 76063-3825
(330) 495-6359
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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