Provider Demographics
NPI:1255818027
Name:VETTER, JAMES ROBERT JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:VETTER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 MACKINAW RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14129-9722
Mailing Address - Country:US
Mailing Address - Phone:716-392-7853
Mailing Address - Fax:
Practice Address - Street 1:12333 MACKINAW RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:NY
Practice Address - Zip Code:14129-9722
Practice Address - Country:US
Practice Address - Phone:716-392-7853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)