NPI 1851711477

Adolescent Escort Service

Organisation Private Vehicle Washington, UT

Practice location

Address: 1865 S Cantle Cir, Washington, UT 84780-2121
Phone: (435) 701-6984

Authorised official

Name: Ian Gerritsen
Title: Owner
Phone: (435) 701-6984

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 1796 (UT)

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Registry record

NPI: 1851711477
Entity type: Organization
NPI issued: 22 Apr 2014
Record last updated: 22 Apr 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.