Healthcare Provider Details

I. General information

NPI: 1780305474
Provider Name (Legal Business Name): VUEON CREATOR SPACE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41900 MIDTOWN CIR UNIT 208
NOVI MI
48375-1964
US

IV. Provider business mailing address

41900 MIDTOWN CIR UNIT 208
NOVI MI
48375-1964
US

V. Phone/Fax

Practice location:
  • Phone: 248-946-4270
  • Fax:
Mailing address:
  • Phone: 248-946-4270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: NATAUSHA BUSHELL
Title or Position: DIRECTOR
Credential:
Phone: 248-946-4270