Provider Demographics
NPI:1962671438
Name:TROUT LAKE TOWNSHIP
Entity Type:Organization
Organization Name:TROUT LAKE TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOBEE
Authorized Official - Suffix:
Authorized Official - Credentials:EMTB
Authorized Official - Phone:906-569-3291
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:TROUT LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49793
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21501 S BEECH ST
Practice Address - Street 2:
Practice Address - City:TROUT LAKE
Practice Address - State:MI
Practice Address - Zip Code:49793
Practice Address - Country:US
Practice Address - Phone:906-569-3291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1710183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport