| Culver-stockton Sports Medicine | |
|
1 College Hl Canton MO 63435-1257 | |
| (972) 367-4845 | |
| Not Available |
| Full Name | Culver-stockton Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1 College Hl, Canton, Missouri |
| Authorized Official Name and Position | Mouzon Bass (AGENT) |
| Authorized Official Contact | 9723674845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Culver-stockton Sports Medicine 5050 Spring Valley Rd Dallas TX 75244-3995 Ph: () - | Culver-stockton Sports Medicine 1 College Hl Canton MO 63435-1257 Ph: (972) 367-4845 |
| NPI Number | 1952839789 |
|---|---|
| Provider Enumeration Date | 05/24/2017 |
| Last Update Date | 05/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952839789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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