Provider Demographics
NPI:1669760914
Name:DRIVERS DYNAMIC
Entity type:Organization
Organization Name:DRIVERS DYNAMIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION CORRDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-589-4617
Mailing Address - Street 1:1044 W BRISTOL RD
Mailing Address - Street 2:APT.206-1
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-5516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1044 W BRISTOL RD
Practice Address - Street 2:APT.206-1
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5516
Practice Address - Country:US
Practice Address - Phone:616-589-4617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker