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General NPI Number Information
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NPI Number | 1790042927
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Entity Type | Organization
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Legal Business Name | LOUANGE SERVICES INC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 3270 MOON BEAM CT
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City | SNELLVILLE
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State | GA
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Zip | 30039-6130
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Country | US
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Telephone | 404-992-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 3270 MOON BEAM CT
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City | SNELLVILLE
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State | GA
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Zip | 30039-6130
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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 | PHYSICAL THERAPIST
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Name | AYODEJI OWOYOMI
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Credential |
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Telephone | 404-992-8437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | GA
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