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General NPI Number Information
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NPI Number | 1760472229
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Entity Type | Organization
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Legal Business Name | CITY OF OCONTO
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 1210 MAIN ST
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City | OCONTO
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State | WI
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Zip | 54153-1542
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Country | US
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Telephone | 920-834-7711
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Fax | 920-834-7713
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Provider Business Mailing Address
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Address Line | 1210 MAIN ST
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City | OCONTO
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State | WI
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Zip | 54153-1542
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Country | US
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Telephone | 920-834-7711
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Fax | 920-834-7713
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Authorized Official
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Title or Position | DEPUTY CLERK/TREASURER
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Name | MS. CAROL F STEWART
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Credential |
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Telephone | 920-834-7711
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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 | 6001007
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License Number State | WI
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