Organization
CITY OF LAKE MILLS
Active
Other names
City of Lake Mills Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL SCOTT THEDER AEMT (CAPTAIN)
(920) 648-5117
Entity
Organization
Contact information
Practice address
120 VETERANS LN, LAKE MILLS, WI 53551-1555
(920) 648-5117
(920) 648-8743
Mailing address
200D WATER ST, LAKE MILLS, WI 53551-1632
(920) 648-5117
(920) 648-8743
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6600034
SERVICE LICENSE NUMBER
WI
Enumeration date
11/03/2022
Last updated
11/07/2022
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