Organization
SO. GREEN LAKE CO. SENIOR TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY M BENDER (PROJECT MANAGER)
(920) 394-3008
Entity
Organization
Contact information
Practice address
N1440 SPRING LAKE DR, DALTON, WI 53926-9229
(920) 394-3008
Mailing address
N1440 SPRING LAKE DR, DALTON, WI 53926-9229
(920) 394-3008
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
02/10/2009
Last updated
02/10/2009
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