Organization
TOWN OF LONG LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF KISLEWSKI (DIRECTOR)
(717) 724-4136
Entity
Organization
Contact information
Practice address
3348 WISCONSIN 139, LONG LAKE, WI 54542
(715) 674-2263
Mailing address
PO BOX 138, LONG LAKE, WI 54542-0138
(715) 674-2263
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6604974
WI
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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