Organization
COUNT OWN TRANSPORTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REAGON WILSON OWNER (OWNER/MANAGER)
(901) 273-4330
Entity
Organization
Contact information
Practice address
4093 PONCA ST, MEMPHIS, TN 38109
(901) 273-4330
Mailing address
4093 PONCA ST, MEMPHIS, TN 38109
(901) 273-4330
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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