Derrick K Staten
Derrick K Staten is a Non-emergency Medical Transport (VAN) in Mableton, Georgia. Practices as a sole proprietor. Licensed in Georgia.
- Licensed in
- GA
- In the registry since
- 2024
Practice location Address checks out
518 Mount Gerizim Rd SEMableton, GA 30126-6410
Phone: (470) 654-2331
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Non-emergency Medical Transport (VAN) (primary) | Taxonomy 343900000X · Licence 24064864 (GA) |
|---|
Record details
| NPI number | 1891540555 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 17, 2024 |
| Last updated in NPPES | April 17, 2024 |
| Certification date | April 17, 2024 |
| Mailing address | 518 Mount Gerizim Rd Se, Mableton, GA 30126-6410 |
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