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General NPI Number Information
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NPI Number | 1790319531
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Entity Type | Organization
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Legal Business Name | CHOZEN ONE TRANSPORTATION
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 342 S MAIN ST
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City | THOMASTON
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State | GA
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Zip | 30286-3105
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Country | US
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Telephone | 678-396-0266
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Fax |
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Provider Business Mailing Address
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Address Line | 342 S MAIN ST
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City | THOMASTON
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State | GA
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Zip | 30286-3105
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Country | US
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Telephone | 678-396-0266
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Fax |
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Authorized Official
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Title or Position | OWNER/ DRIVER
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Name | MARY RODGERS
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Credential |
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Telephone | 678-396-0266
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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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