Provider Demographics
NPI:1225729163
Name:CHIRI, URGESA USSEN (TRANSPORTATIONS SER)
Entity Type:Individual
Prefix:
First Name:URGESA
Middle Name:USSEN
Last Name:CHIRI
Suffix:
Gender:M
Credentials:TRANSPORTATIONS SER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12261 71ST ST NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-2964
Mailing Address - Country:US
Mailing Address - Phone:612-685-6511
Mailing Address - Fax:
Practice Address - Street 1:9436 ULYSSES ST NE UNIT 324
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3587
Practice Address - Country:US
Practice Address - Phone:612-685-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6278631347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker