Organization
TOWN OF BRAZEAU
Active
Other names
Town of Brazeau Rescue Squad
Organization subpart
No
Provider details
NPI number
Authorized official
SUE KANACK (PRESIDENT)
(920) 897-2793
Entity
Organization
Contact information
Practice address
12071 PARKWAY RD, POUND, WI 54161-8707
(920) 897-2793
Mailing address
9151 GRAVEL LN, LENA, WI 54139-9774
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080014
ADVOCARE MCHMO
—
01
—
12916
NETWORK HEALTH
—
01
—
41317700
HIRSP
WI
05
—
41317700
—
WI
01
—
WI0101
JOHN DEERE
—
Enumeration date
05/19/2006
Last updated
09/05/2012
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