| NPI | 1649765736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH WILSON Owner 715-559-5712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-06-29 |