Organization
CITY OF LASALLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW ANTONE BACIDORE EMT-BASIC (FIRE CHIEF)
(815) 223-0834
Entity
Organization
Contact information
Practice address
745 2ND ST, LA SALLE, IL 61301-2501
(815) 223-4579
(815) 223-0857
Mailing address
745 2ND ST, LA SALLE, IL 61301-2501
(815) 223-4579
(815) 223-0857
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
022482
IL
Other
Enumeration date
11/23/2010
Last updated
12/09/2010
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