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Organization
MADISON GRACE TRANSPORT LLC
Active
Organization
MADISON GRACE TRANSPORT LLC
Active
Other names
Madison Grace Transport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE LEE SULLIVAN (OWNER)
(601) 618-0175
Entity
Organization
Contact information
Practice address
126 LE FLEURS DR, VICKSBURG, MS 39180-8850
(801) 618-0175
Mailing address
126 LE FLEURS DR, VICKSBURG, MS 39180-8850
(801) 618-0175
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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