Individual
WILLIE L JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19351 JEFFERSON RD, WHITE SPRINGS, FL 32096
(386) 397-1879
Mailing address
PO BOX 395, WHITE SPRINGS, FL 32096
(386) 397-1879
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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