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General NPI Number Information
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NPI Number | 1073509121
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Entity Type | Organization
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Legal Business Name | SYCAMORE VILLAGE OFFICE OF CLERK
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 106 E SEVENTH ST
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City | SYCAMORE
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State | OH
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Zip | 44849
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Country | US
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Telephone | 419-927-2900
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Fax | 419-927-2988
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Provider Business Mailing Address
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Address Line | PO BOX 77 106 E SEVENTH STREET
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City | SYCAMORE
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State | OH
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Zip | 44882-0077
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Country | US
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Telephone | 419-927-2900
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Fax | 419-927-2988
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Authorized Official
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Title or Position | CHIEF
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Name | MR. BRYAN CLOUSE
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Credential |
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Telephone | 419-397-2063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 020299904
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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