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General NPI Number Information
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NPI Number | 1710922620
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Entity Type | Organization
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Legal Business Name | TROUTLAND RESCUE SQUAD, INC.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 113 BISSELL ST
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City | WHITE LAKE
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State | WI
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Zip | 54491-9410
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Country | US
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Telephone | 715-432-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 700 EDISON ST
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City | ANTIGO
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State | WI
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Zip | 54409-1955
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Country | US
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Telephone | 715-623-3633
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Fax | 715-627-4761
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Authorized Official
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Title or Position | BILLING SECRETARY
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Name | MRS. LINDA J VOLLMAR
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Credential |
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Telephone | 715-623-3633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 60-01159
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License Number State | WI
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