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General NPI Number Information
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NPI Number | 1679439293
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Entity Type | Organization
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Legal Business Name | FOREVER YOUNG TRUCKING LLC
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Dates
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Enumeration Date | 12/27/2025
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 3200 LENOX RD NE APT A102
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City | ATLANTA
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State | GA
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Zip | 30324-2601
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Country | US
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Telephone | 470-494-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 LENOX RD NE APT A102
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City | ATLANTA
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State | GA
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Zip | 30324-2601
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Country | US
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Telephone | 470-494-5588
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DANIELLE LYNNETTE YOUNG
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Credential |
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Telephone | 470-494-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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