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NORTHWEST CHRISTIAN UNIVERSITY

Physicians Pediatrics Sports Medicine

Provider NPI: 1487020640

Organization Information:
Organization Name:  NORTHWEST CHRISTIAN UNIVERSITY
Organization is not Subpart
Authorized Official:  MOUZON  BASS  AGENT  972-367-4845

Practice Location:
828 E 11TH AVE  EUGENE, OR 97401-3745 US
Tel: 541-684-7351  Fax: 972-367-3451

Business Mailing Address:
PO BOX 650850  DALLAS, TX 75265-0850 US
Tel: 800-555-9073  Fax: 972-367-3452

NPI Information:
NPI: 1487020640
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2080S0010XPhysicians
Pediatrics
Sports Medicine

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 2080S0010X

Type:

Classification:



Definition:



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