NPI | 1023219094 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD L KOELLING President / Supervisor 815-865-5153 |
Organization Subpart ? | No |
Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: IL 01103601) |
Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
Enumeration Date | 2007-05-29 |
Last Update Date | 2012-03-28 |