Organization
ON THE WAY TRANSPORTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACKQULINE DENISE BUTLER (OWNER)
(318) 470-8454
Entity
Organization
Contact information
Practice address
3600 COLQUITT RD, SHREVEPORT, LA 71118-4224
(318) 470-8454
Mailing address
PO BOX 6541, SHREVEPORT, LA 71136-6541
(318) 470-8454
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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