Healthcare Provider Details

I. General information

NPI: 1063358414
Provider Name (Legal Business Name): PLACE TO PLACE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 OSMOND AVE
DAYTON OH
45417-1557
US

IV. Provider business mailing address

635 OSMOND AVE
DAYTON OH
45417-1557
US

V. Phone/Fax

Practice location:
  • Phone: 937-478-6773
  • Fax:
Mailing address:
  • Phone: 937-478-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: KENNETH MAKUPSON
Title or Position: OWNER
Credential:
Phone: 937-478-6773