| Liberty Sports Medicine | |
|
1971 University Blvd Lynchburg VA 24515-0002 | |
| (972) 367-4845 | |
| Not Available |
| Full Name | Liberty Sports Medicine |
|---|---|
| Speciality | General Practice |
| Location | 1971 University Blvd, Lynchburg, Virginia |
| Authorized Official Name and Position | Mouzon Bass (ADMINISTRATOR) |
| Authorized Official Contact | 9723674845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Sports Medicine 5050 Spring Valley Rd Dallas TX 75244-3995 Ph: () - | Liberty Sports Medicine 1971 University Blvd Lynchburg VA 24515-0002 Ph: (972) 367-4845 |
| NPI Number | 1750848644 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 02/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750848644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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