Individual
MR. HENOK TAMIRAT ABDISA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TRANSPORT PROVIDER
Contact information
Practice address
4715 NW FLINTRIDGE RD, RIVERSIDE, MO 64150-1153
(816) 328-8007
Mailing address
4715 NW FLINTRIDGE RD, RIVERSIDE, MO 64150-1153
(816) 328-8007
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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