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.
Location: 711 N State St, Grangeville, ID, 83530-1650
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
Provider Business Practice Location Address Details
Address
711 N State St
City
State
Zip
83530-1650
Phone Number
208-507-2160
Fax Number
Provider Business Mailing Address Details
Address
711 N State St
City
State
Zip
83530-1650
Phone Number
208-507-2160
Fax Number
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
License No.
WA116016B (Idaho)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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