Active Lane LLC
NPI #1356009401 in Cedar Rapids, Iowa
Provider Information
- NPI Number
- 1356009401
- Entity Type
- Organization
- Organization Name
- Active Lane LLC
- Primary Specialty
- Non-emergency Medical Transport (VAN)
- Enumeration Date
- Dec 6, 2021
- Last Updated
- Dec 6, 2021
Practice Location
- Address
- 6722 COLLEGE PARK CT SW APT 8
- City
- Cedar Rapids
- State
- Iowa
- ZIP Code
- 52404-7511
- Phone
- (682) 241-0907
Authorized Official
- Name
- MR. THEOPHILE NIZIGAMA
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (682) 241-0907
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-emergency Medical Transport (VAN) |
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