Provider Demographics
NPI:1760945760
Name:BATTLE, VALISHO MARGARINE (TRANSPORTATION)
Entity Type:Individual
Prefix:
First Name:VALISHO
Middle Name:MARGARINE
Last Name:BATTLE
Suffix:
Gender:F
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 ALEXIS CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37406-1281
Mailing Address - Country:US
Mailing Address - Phone:423-291-6164
Mailing Address - Fax:
Practice Address - Street 1:3505 BRAINERD RD STE 2/3
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-2709
Practice Address - Country:US
Practice Address - Phone:423-291-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN074540023172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver