Organization
WHITE LAKE AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHON DEGEN (DIRECTOR)
(231) 894-4306
Entity
Organization
Contact information
Practice address
5085 WILCOX ST, MONTAGUE, MI 49437-1558
(231) 894-4306
(231) 893-0249
Mailing address
5085 WILCOX ST, MONTAGUE, MI 49437-1558
(231) 894-4306
(231) 893-0249
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
611002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4217295
—
MI
Enumeration date
06/20/2005
Last updated
06/29/2016
Update your record
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