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General NPI Number Information
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NPI Number | 1225729163
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Entity Type | Individual
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Provider Name | URGESA USSEN CHIRI TRANSPORTATIONS SER.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 9436 ULYSSES ST NE UNIT 324
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City | BLAINE
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State | MN
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Zip | 55434-3587
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Country | US
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Telephone | 612-685-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 12261 71ST ST NE
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City | OTSEGO
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State | MN
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Zip | 55330-2964
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Country | US
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Telephone | 612-685-6511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number | 6278631
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License Number State | MN
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