Organization
LEGACY LANE TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JORDAN (OWNER/OPERATOR)
(414) 458-4259
Entity
Organization
Contact information
Practice address
2762 N WAUWATOSA AVE, WAUWATOSA, WI 53222-5006
(414) 458-4259
Mailing address
2762 N WAUWATOSA AVE, WAUWATOSA, WI 53222-5006
(414) 458-4259
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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