Wagon Trail Professional Transport LLC
NPI #1124455357 in Fort Defiance, Arizona
Provider Information
- NPI Number
- 1124455357
- Entity Type
- Organization
- Organization Name
- Wagon Trail Professional Transport LLC
- Primary Specialty
- Non-emergency Medical Transport (VAN)
- Enumeration Date
- Oct 2, 2013
- Last Updated
- Oct 2, 2013
Practice Location
- Address
- 24 SLICK ROCK DR
- City
- Fort Defiance
- State
- Arizona
- ZIP Code
- 86504
- Phone
- (928) 729-2944
Authorized Official
- Name
- FORREST LOWLEY
- Title
- OWNER
- Phone
- (928) 729-2944
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-emergency Medical Transport (VAN) |
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