| Western New England University Sports Medicine | |
|
1215 Wilbraham Rd Springfield MA 01119-2612 | |
| (413) 782-1202 | |
| (972) 367-3451 |
| Full Name | Western New England University Sports Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 1215 Wilbraham Rd, Springfield, Massachusetts |
| 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 |
|---|---|
| Western New England University Sports Medicine Po Box 650850 Dept 1011 Dallas TX 75265-0850 Ph: (972) 367-4845 | Western New England University Sports Medicine 1215 Wilbraham Rd Springfield MA 01119-2612 Ph: (413) 782-1202 |
| NPI Number | 1356713572 |
|---|---|
| Provider Enumeration Date | 10/27/2015 |
| Last Update Date | 10/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356713572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RS0010X | Internal Medicine - Sports Medicine | (* (Not Available)) | Secondary |
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