Organization
CITY OF MEQUON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS WATSON (FINANCE DIRECTOR)
(262) 236-2948
Entity
Organization
Contact information
Practice address
11300 N BUNTROCK AVE, MEQUON, WI 53092-1843
(262) 242-0205
Mailing address
11333 N CEDARBURG RD, MEQUON, WI 53092-1930
(262) 236-2948
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6000977
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41331300
—
WI
Enumeration date
05/28/2006
Last updated
08/22/2020
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