# CITY OF LAKE GENEVA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760438246
- **Authorized official:** MS. DIANA DYKSTRA (CITY CLERK)
- **Authorized official phone:** (262) 248-3673

## Contact information

- **Practice address:** 730 MARSHALL ST, LAKE GENEVA, WI 53147-1436
- **Practice address phone:** (262) 248-3673
- **Practice address fax:** (262) 248-4715
- **Mailing address:** 626 GENEVA ST, CITY HALL, LAKE GENEVA, WI 53147-1914
- **Mailing address phone:** (262) 248-3673
- **Mailing address fax:** (262) 248-4715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 6001201 | WI | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 06/20/2008