Southeast Missouri State University
NPI #1871003301 in Cape Girardeau, Missouri
Provider Information
- NPI Number
- 1871003301
- Entity Type
- Organization
- Organization Name
- Southeast Missouri State University
- Primary Specialty
- Physical Medicine & Rehabilitation - Sports Medicine
- Enumeration Date
- Oct 11, 2017
- Last Updated
- Dec 17, 2021
Practice Location
- Address
- 1 UNIVERSITY PLZ # MS 0200
- City
- Cape Girardeau
- State
- Missouri
- ZIP Code
- 63701-4710
- Phone
- (972) 367-4845
Authorized Official
- Name
- MOUZON BASS III
- Title
- AGENT
- Phone
- (972) 367-4845
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Medicine & Rehabilitation - Sports Medicine — Sports Medicine |
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