Organization
LONG LAKE-TIPLER RESCUE SQUAD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE GORR (PRESIDENT)
(715) 889-4592
Entity
Organization
Contact information
Practice address
11098 DREAM LAKE RD, TIPLER, WI 54542
(715) 889-2674
Mailing address
PO BOX 137, LONG LAKE, WI 54542-0137
(715) 889-2674
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41314500
—
WI
Enumeration date
09/14/2007
Last updated
02/09/2018
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