Healthcare Provider Details

I. General information

NPI: 1164828083
Provider Name (Legal Business Name): GT MOBILITY & SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 ONTARIO RD
GREEN BAY WI
54311-8018
US

IV. Provider business mailing address

844 ONTARIO RD
GREEN BAY WI
54311-8018
US

V. Phone/Fax

Practice location:
  • Phone: 920-491-8384
  • Fax: 920-491-8387
Mailing address:
  • Phone: 920-491-8384
  • Fax: 920-491-8387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: TODD NAULT
Title or Position: MANAGING MEMBER
Credential:
Phone: 920-491-8384