Organization
CITY OF LAKE GENEVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA DYKSTRA (CITY CLERK)
(262) 248-3673
Entity
Organization
Contact information
Practice address
730 MARSHALL ST, LAKE GENEVA, WI 53147-1436
(262) 248-3673
(262) 248-4715
Mailing address
626 GENEVA ST, CITY HALL, LAKE GENEVA, WI 53147-1914
(262) 248-3673
(262) 248-4715
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6001201
WI
Other
Enumeration date
05/26/2006
Last updated
06/20/2008
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