| NPI | 1013466135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUENTIN RAYMONE CROCKETT President 773-886-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: GA 050473793) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |