Healthcare Provider Details

I. General information

NPI: 1336732908
Provider Name (Legal Business Name): MJ TRANSPORTATION SERVICES MELISSA JO DAHLSTROM GEN PTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HIDDEN VLY
MINNESOTA CITY MN
55959-1231
US

IV. Provider business mailing address

185 HIDDEN VLY
MINNESOTA CITY MN
55959-1231
US

V. Phone/Fax

Practice location:
  • Phone: 507-313-9760
  • Fax:
Mailing address:
  • Phone: 507-313-9760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA JO DAHLSTROM
Title or Position: CO-OWNER
Credential:
Phone: 507-313-9760