Organization
GREAT LAKES EMS INC.
Active
Other names
Action Sports EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN C MC CLINTOCK NREMT (DIRECTOR)
(715) 889-4491
Entity
Organization
Contact information
Practice address
W521 HACKER ROAD, 410, BRILLION, WI 54110-4136
(715) 889-4491
(855) 425-3066
Mailing address
PO BOX 33, BRILLION, WI 54110-0033
(715) 889-4491
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
03 3099
IL
3416L0300X
Land Ambulance
6604935
WI
Other
Enumeration date
03/25/2013
Last updated
02/08/2021
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