Provider Demographics
NPI:1114795283
Name:WESLEY, TORWIN (OWNER)
Entity Type:Individual
Prefix:MR
First Name:TORWIN
Middle Name:
Last Name:WESLEY
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:501 N SLAPPEY BLVD # 1037
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1409
Mailing Address - Country:US
Mailing Address - Phone:229-484-8556
Mailing Address - Fax:470-221-1300
Practice Address - Street 1:1615 WEST 3RD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707
Practice Address - Country:US
Practice Address - Phone:229-484-8556
Practice Address - Fax:470-221-1300
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)