| Imagine A Child's Capacity | |
|
2875 Fish Hatchery Rd Fitchburg WI 53713-3114 | |
| (608) 204-6242 | |
| (608) 204-6249 |
| Full Name | Imagine A Child's Capacity |
|---|---|
| Speciality | Clinic/center - Rehabilitation |
| Location | 2875 Fish Hatchery Rd, Fitchburg, Wisconsin |
| Authorized Official Name and Position | David Johnson (EXECUTIVE DIRECTOR.) |
| Authorized Official Contact | 6083161127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine A Child's Capacity 2875 Fish Hatchery Rd Fitchburg WI 53713-3114 Ph: (608) 204-6242 | Imagine A Child's Capacity 2875 Fish Hatchery Rd Fitchburg WI 53713-3114 Ph: (608) 204-6242 |
| NPI Number | 1770688970 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 03/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770688970 | NPI | - | NPPES |
| 41225100 | Medicaid | WI |
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