| NPI | 1255457636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADY LOGAN CRANE Administrative Assistant 618-964-1278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: IL 055218) |
| Additional Taxonomies | 3416L0300X Ambulance, Land Transport (Licence: IL 1770271) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2013-01-11 |