Organization
LIFESTYLES
Active
Other names
Bakken Bandits Transport, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWIGHT C BOYD N-A (CEO)
(928) 326-0044
Entity
Organization
Contact information
Practice address
4385 E WILD ELK TRL, FLAGSTAFF, AZ 86004-7921
(928) 326-0044
Mailing address
4385 E WILD ELK TRL, FLAGSTAFF, AZ 86004-7921
(928) 326-0044
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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