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Edie Lustig
Private Vehicle in Grangeville, Idaho
NPI 1164988663

Edie Lustig is a Private Vehicle based in Grangeville, ID. Edie Lustig practices in Grangeville, ID. The NPI Number for Edie Lustig is 1164988663 and holds a License No. WA116016B (Idaho).

The current practice location address for Edie Lustig is 711 N State St, Grangeville, ID and can be reached out via phone at 208-507-2160. You can also correspond with Edie Lustig through the mailing address at 711 N STATE ST, GRANGEVILLE, ID - 83530-1650 (mailing address contact number: 208-507-2160).

Location: 711 N State St, Grangeville, ID, 83530-1650
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164988663
Provider Name
Edie Lustig
Credential
Provider Entity Type
Individual
Gender
Female
Address
711 N State St, Grangeville, ID, 83530-1650
Phone Number
208-507-2160
Fax Number
Provider Enumeration Date
02/20/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
711 N State St
City
Grangeville
State
Idaho
Zip
83530-1650
Phone Number
208-507-2160
Fax Number
person
Provider Business Mailing Address Details
Address
711 N State St
City
Grangeville
State
Idaho
Zip
83530-1650
Phone Number
208-507-2160
Fax Number
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
WA116016B (Idaho)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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