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General NPI Number Information
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NPI Number | 1053070722
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Entity Type | Organization
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Legal Business Name | MOE TRANSPORTATION INC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 350 W JOHN CASEY RD APT 1
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City | BOURBONNAIS
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State | IL
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Zip | 60914-3217
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Country | US
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Telephone | 815-922-1778
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Fax |
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Provider Business Mailing Address
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Address Line | 350 W JOHN CASEY RD APT 1
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City | BOURBONNAIS
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State | IL
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Zip | 60914-3217
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Country | US
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Telephone | 815-922-1778
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/TRANSPORTATION
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Name | GREGORY KEEL
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Credential | PRESIDENT
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Telephone | 815-922-1778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XR0403X
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Taxonomy Name | Driving and Community Mobility Occupational Therapist
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License Number |
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License Number State |
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