Organization
SAGINAW VALLEY STATE UNIVERSITY
Active
Other names
Saginaw Valley State University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (ADMINISTRATOR BY AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
7400 BAY RD, UNIVERSITY CENTER, MI 48710-0001
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(972) 367-4845
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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