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Organization

OUTREACH TRANSPORTATION SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RONETTA ANNE WILSON (OWNER)
(770) 572-5336
Entity
Organization

Contact information

Practice address
945 CRESTMARK BLVD APT 329, LITHIA SPRINGS, GA 30122-2628
(770) 572-5336
Mailing address
945 CRESTMARK BLVD APT 329, LITHIA SPRINGS, GA 30122-2628
(770) 572-5336

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
15-00011334
GA

Other

Enumeration date
07/15/2015
Last updated
07/15/2015
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