Provider Demographics
NPI:1336732908
Name:MJ TRANSPORTATION SERVICES MELISSA JO DAHLSTROM GEN PTR
Entity Type:Organization
Organization Name:MJ TRANSPORTATION SERVICES MELISSA JO DAHLSTROM GEN PTR
Other - Org Name:MJ TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DAHLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-313-9760
Mailing Address - Street 1:185 HIDDEN VLY
Mailing Address - Street 2:
Mailing Address - City:MINNESOTA CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55959-1231
Mailing Address - Country:US
Mailing Address - Phone:507-313-9760
Mailing Address - Fax:
Practice Address - Street 1:185 HIDDEN VLY
Practice Address - Street 2:
Practice Address - City:MINNESOTA CITY
Practice Address - State:MN
Practice Address - Zip Code:55959-1231
Practice Address - Country:US
Practice Address - Phone:507-313-9760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi