| Weslyan Sports Medicine | |
|
237 High St Middletown CT 06459-0850 | |
| (860) 685-3068 | |
| (972) 367-3451 |
| Full Name | Weslyan Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 237 High St, Middletown, Connecticut |
| 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 |
|---|---|
| Weslyan Sports Medicine Po Box 650850 Dallas TX 75265-0850 Ph: (800) 555-9073 | Weslyan Sports Medicine 237 High St Middletown CT 06459-0850 Ph: (860) 685-3068 |
| NPI Number | 1194104224 |
|---|---|
| Provider Enumeration Date | 05/21/2015 |
| Last Update Date | 05/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194104224 | 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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