| Dsu Sports Medicine | |
|
225 S 700 E St George UT 84770-3875 | |
| (435) 652-7850 | |
| (972) 367-3452 |
| Full Name | Dsu Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 225 S 700 E, St George, Utah |
| 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 |
|---|---|
| Dsu Sports Medicine Po Box 650850 Dallas TX 75265-0850 Ph: (800) 555-9073 | Dsu Sports Medicine 225 S 700 E St George UT 84770-3875 Ph: (435) 652-7850 |
| NPI Number | 1316323165 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 08/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316323165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
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