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Organization

EXPRESS TRANSPORTATION OF WI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID DEVEREAUX (CO-OWNER)
(414) 235-3668
Entity
Organization

Contact information

Practice address
9675 S 54TH ST, FRANKLIN, WI 53132-9825
(414) 235-3668
(414) 235-4933
Mailing address
9675 S 54TH ST, FRANKLIN, WI 53132-9825
(414) 235-3668
(414) 235-4933

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
100005686
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100005686
WI
Enumeration date
04/05/2010
Last updated
04/05/2010
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