| NPI | 1770649360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD RUSSELL Owner 815-235-2353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: IL 1616904) |
| Additional Taxonomies | 3416L0300X Ambulance, Land Transport (Licence: IL 1616905) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |