Organization
BRIGHAM YOUNG UNIVERSITY
Active
Other names
BYU Dance
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
173 RICHARDS BUILDING, DANCE DEPARTMENT, PROVO, UT 84602-2000
(972) 367-4845
(972) 367-3452
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(972) 367-4845
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/30/2015
Last updated
05/11/2017
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