MOUFOUTAHO LIASSOU
Transportation at Iona St, Providence, RI

License number
Rhode Island PMV-302
Category
Transportation
Type
Non-emergency Medical Transport (VAN)
Address
Address
59 Iona St, Providence, RI 02908
Phone
(401) 601-5857
National Provider ID: 1699115444
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Personal information

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Name
Address
Phone
Moufoutaho Liassou, age 52
61 Cleveland St, Pawtucket, RI 02860
Moufoutaho Liassou
59 Iona St, Providence, RI 02908

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