NPI 1194121210

Boomer Ride

Organisation Private Vehicle Hastings, MN

Practice location

Address: 724 5th St W APT B, Hastings, MN 55033-1745
Phone: (651) 263-0189

Authorised official

Name: Leslie Dean Howard
Title: Owner
Phone: (651) 263-0189

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence C893012006120 (MN)

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Registry record

NPI: 1194121210
Entity type: Organization
NPI issued: 17 Nov 2014
Record last updated: 17 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.