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Individual

DAMIEN PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1087 WESTPORT DR APT 155, PORT WASHINGTON, WI 53074-2481
(414) 208-0605
(262) 364-2336
Mailing address
1087 WESTPORT DR APT 155, PORT WASHINGTON, WI 53074-2481
(414) 208-0605
(262) 364-2336

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
100043804
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100043804
WI
Enumeration date
07/27/2015
Last updated
07/27/2015
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