Alabama State University
NPI #1205356938 in Montgomery, Alabama
Provider Information
- NPI Number
- 1205356938
- Entity Type
- Organization
- Organization Name
- Alabama State University
- Primary Specialty
- Orthopaedic Surgery - Sports Medicine
- Enumeration Date
- Jun 23, 2017
- Last Updated
- Jun 23, 2017
Practice Location
- Address
- 915 S JACKSON ST
- City
- Montgomery
- State
- Alabama
- ZIP Code
- 36104-5716
- Phone
- (972) 367-4845
Authorized Official
- Name
- MOUZON BASS III
- Title
- AGENT
- Phone
- (972) 367-4845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Orthopaedic Surgery - Sports Medicine — Sports Medicine |
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