Provider Demographics
NPI:1912676495
Name:TURNER, MICO B (OWNER)
Entity type:Individual
Prefix:
First Name:MICO
Middle Name:B
Last Name:TURNER
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:TEARS OF JOY NON
Other - Middle Name:
Other - Last Name:EMERGENCY TRANSPORTION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COMPANY NAME
Mailing Address - Street 1:PO BOX 94881
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30377-1881
Mailing Address - Country:US
Mailing Address - Phone:678-964-5133
Mailing Address - Fax:
Practice Address - Street 1:1829 CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-2729
Practice Address - Country:US
Practice Address - Phone:678-964-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver