Provider Demographics
NPI:1770839946
Name:JEFF'S OUTDOOR SERVICES
Entity type:Organization
Organization Name:JEFF'S OUTDOOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:JAHNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-221-1416
Mailing Address - Street 1:16072 HENRIETTE RD
Mailing Address - Street 2:
Mailing Address - City:PINE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55063-5192
Mailing Address - Country:US
Mailing Address - Phone:612-221-1416
Mailing Address - Fax:
Practice Address - Street 1:16072 HENRIETTE RD
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-5192
Practice Address - Country:US
Practice Address - Phone:612-221-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty