| NPI | 1053169169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH QUINCY CANNON President/Owner 262-672-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |