Organization
FAST LAINE TRANSPORT II
Active
Other names
Fast Laine Transport II
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELAINE PORTER (OWNER)
(414) 324-4663
Entity
Organization
Contact information
Practice address
4724 W DEER RUN DR APT 105, BROWN DEER, WI 53223-6423
(414) 324-4663
Mailing address
4724 W DEER RUN DR APT 105, BROWN DEER, WI 53223-6423
(414) 324-4663
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6361925727104
DRIVERS LICENSE
WI
Enumeration date
01/19/2022
Last updated
01/19/2022
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