W.b. Stewart Tigers Athletics Boosters
W.b. Stewart Tigers Athletics Boosters provides Pediatric Adolescent Medicine Physician services in Jacksonville, Florida. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
1658 Kings RdJacksonville, FL 32209-6167
Phone: (972) 367-4845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Adolescent Medicine Physician (primary) | Taxonomy 2080A0000X |
|---|
Record details
| NPI number | 1841794682 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mouzon Bass — Agent · (972) 367-4845 |
| Other names | Ewc Sports Medicine |
| NPI enumerated | March 19, 2018 |
| Last updated in NPPES | March 19, 2018 |
| Mailing address | 5050 Spring Valley Rd, Dallas, TX 75244-3995 |
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