Organization
BROTOLOC SESMV
Active
Other names
Brotoloc
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG SVEDA MSW (DIRECTOR)
(414) 543-3200
Entity
Organization
Contact information
Practice address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Mailing address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
NONE
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41487500
—
WI
Enumeration date
02/14/2007
Last updated
08/22/2020
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