Sport Is Religion

NPI #1093334039 in Fort Worth, Texas

Provider Information

NPI Number: 1093334039
Entity Type: Organization
Organization Name: Sport Is Religion
Primary Specialty: Specialist
Enumeration Date: Apr 9, 2020
Last Updated: Apr 9, 2020

Practice Location

Address: 8641 LAS VEGAS CT APT 2722
City: Fort Worth
State: Texas
ZIP Code: 76116-0044
Phone: (682) 785-7348

Authorized Official

Name: MS. BREANNA N EDWARDS
Title: DIRECTOR OF OPERATIONS
Phone: (682) 785-7348

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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