Organization
LINDENWOOD UNIVERSITY
Active
Organization
LINDENWOOD UNIVERSITY
Active
Other names
Lindenwood University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1693
(636) 949-2000
Mailing address
5050 SPRING VALLEY RD., DALLAS, TX 75244-3909
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2013027435
MO
Other
Enumeration date
09/01/2016
Last updated
09/07/2016
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