Provider Demographics
NPI:1881189793
Name:ABOVE AVERAGE PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:ABOVE AVERAGE PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ECO
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-527-4451
Mailing Address - Street 1:PO BOX 82854
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-9442
Mailing Address - Country:US
Mailing Address - Phone:678-527-4451
Mailing Address - Fax:678-806-4828
Practice Address - Street 1:3672 SHALE LN SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5112
Practice Address - Country:US
Practice Address - Phone:678-527-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle