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General NPI Number Information
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NPI Number | 1396955860
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Entity Type | Organization
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Legal Business Name | CHETEK AMBULANCE SERVICE
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1224 RAILROAD AVE
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City | CHETEK
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State | WI
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Zip | 54728-0047
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Country | US
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Telephone | 715-924-4211
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Fax | 715-924-4695
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Provider Business Mailing Address
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Address Line | PO BOX 47
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City | CHETEK
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State | WI
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Zip | 54728-0047
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Country | US
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Telephone | 715-924-4211
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Fax | 715-924-4695
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Authorized Official
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Title or Position | DIRECTOR
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Name | RYAN OLSON
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Credential | AO
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Telephone | 715-924-4211
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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 | 6000571
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License Number State | WI
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