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Organization

KICKAPOO VALLEY RESCUE SQUAD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SADIE J WALLACE (SECRETARY)
(608) 606-3932
Entity
Organization

Contact information

Practice address
213 N TURNER, VIOLA, WI 54664
(608) 627-1810
(608) 627-1815
Mailing address
PO BOX 95, VIOLA, WI 54664-0095
(608) 627-1810
(608) 627-1815

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
60-01171
WI
3416L0300X
Land Ambulance
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41348900
WI
Enumeration date
06/06/2007
Last updated
06/30/2015
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