| NPI | 1245006154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH SHAWN WALL Member/Manager 731-967-2049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2023-12-06 |