Organization
COUNTY OF MARQUETTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY A HOUSLET (DIRECTOR OF EMS)
(608) 297-3125
Entity
Organization
Contact information
Practice address
480 UNDERWOOD AVE, MONTELLO, WI 53949-0181
(608) 297-3125
(608) 297-9176
Mailing address
480 UNDERWOOD AVE, PO BOX 181, MONTELLO, WI 53949-9248
(608) 297-3125
(608) 297-9176
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6000993
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41328900
—
WI
Enumeration date
06/16/2005
Last updated
03/29/2012
Update your record
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