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Organization

WHITE LINE LLC

Active
Other names
Atwood Family
Organization subpart
No

Provider details

NPI number
Authorized official
CLAYTON DRAGGOO (OWNER)
(307) 568-2041
Entity
Organization

Contact information

Practice address
419 W C STREET, BASIN, WY 82410
(307) 568-2041
(307) 568-2727
Mailing address
PO BOX 530, BASIN, WY 82410-0530
(307) 568-2041
(307) 568-2727

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141081400
WY
Enumeration date
04/09/2015
Last updated
06/13/2016
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