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Organization
JAG TRANSPORTATION OF GRAND RAPIDS
Active
Organization
JAG TRANSPORTATION OF GRAND RAPIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZZETTE LIRIO-ONA D.M.D. (OWNER)
(616) 901-8008
Entity
Organization
Contact information
Practice address
5763 E GROVE DR SE, KENTWOOD, MI 49512-9522
(616) 901-8008
Mailing address
5763 E GROVE DR SE, KENTWOOD, MI 49512-9522
(616) 901-8008
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
CMZ7100
MI
347C00000X
Private Vehicle
DBH6287
MI
Other
Enumeration date
09/01/2014
Last updated
09/01/2014
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