| NPI | 1417555475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS PULLIAM Manager 937-361-6471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |