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Organization

CONTINUOUS TRANSPORTATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDUARDO JACOBS (RESIDENT AGENT)
(586) 726-4900
Entity
Organization

Contact information

Practice address
45628 VAN DYKE AVE, UTICA, MI 48317-5366
(586) 726-4900
Mailing address
PO BOX 183382, SHELBY TOWNSHIP, MI 48318-3382

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
802324245
LARA ID NUMBER
MI
Enumeration date
05/28/2019
Last updated
05/28/2019
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