| NPI | 1396507521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANNING DICKERSON BURDEN Owner 769-203-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-01-24 |