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General NPI Number Information
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NPI Number | 1396491122
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Entity Type | Organization
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Legal Business Name | ABC TRANSPORTATION LLC
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 206 S MEMORIAL DR LOWR LEVEL
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City | APPLETON
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State | WI
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Zip | 54911-5839
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Country | US
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Telephone | 920-450-3709
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2464
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City | APPLETON
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State | WI
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Zip | 54912-2464
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAIYOUA THAO
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Credential |
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Telephone | 920-428-6484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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