Healthcare Provider Details

I. General information

NPI: 1063744415
Provider Name (Legal Business Name): L&L TRANSPORTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 TRENT TRL 107 TRENT TRL
SHREVEPORT LA
71106-1843
US

IV. Provider business mailing address

107 TRENT TRL 107 TRENT TRL
SHREVEPORT LA
71106-1843
US

V. Phone/Fax

Practice location:
  • Phone: 318-751-2085
  • Fax:
Mailing address:
  • Phone: 318-751-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number006594297
License Number StateLA

VIII. Authorized Official

Name: MS. LATONYA JOHNSON WATSON
Title or Position: OWNER
Credential:
Phone: 318-751-2085