Organization
PENN TOWNSHIP TTEE
Active
Other names
Penn Township Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS J PORTOLESE (TRUSTEE)
(574) 532-6365
Entity
Organization
Contact information
Practice address
13960 JACKSON RD, MISHAWAKA, IN 46544-9523
(574) 904-5024
(574) 255-4593
Mailing address
PO BOX 2122, RIVERVIEW, MI 48193-1122
(734) 224-4474
(734) 479-6319
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0833
IN
Other
Enumeration date
09/14/2012
Last updated
03/20/2024
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