Organization
GRACELAND UNIVERSITY
Active
Other names
Graceland University SM
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
1 UNIVERSITY PL, LAMONI, IA 50140-1641
(641) 784-5000
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
02206
IA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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