Organization
LIFELINE MOBILE MEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH RICHARD DUTTON (CEO)
(309) 828-8572
Entity
Organization
Contact information
Practice address
112 SOUTHGATE DR, #B, BLOOMINGTON, IL 61704-7639
(309) 828-8572
(309) 827-3060
Mailing address
112 SOUTHGATE DR, #B, BLOOMINGTON, IL 61704-7639
(309) 828-8572
(309) 827-3060
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
IL
Other
Enumeration date
07/31/2006
Last updated
08/22/2020
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