Provider Demographics
NPI:1932647690
Name:LANDERS, TIAUNA SHERI (TSL TRANSPORTATION)
Entity type:Individual
Prefix:
First Name:TIAUNA
Middle Name:SHERI
Last Name:LANDERS
Suffix:
Gender:F
Credentials:TSL TRANSPORTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-0123
Mailing Address - Country:US
Mailing Address - Phone:937-573-1785
Mailing Address - Fax:
Practice Address - Street 1:293 BURMAN AVE
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-2713
Practice Address - Country:US
Practice Address - Phone:937-573-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3984653172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver