Individual
KENNETH AMOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10737 TUTTLE LN, BRISTOW, VA 20136-2803
(973) 280-2123
(703) 594-0224
Mailing address
10737 TUTTLE LN, BRISTOW, VA 20136-2803
(973) 280-2123
(703) 594-0224
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
331
VA
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331
NON-EMERGENCY MEDICAL TRANSPORTATION CARRIER
VA
Enumeration date
05/09/2016
Last updated
05/28/2019
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