IMAGINE A CHILD'S CAPACITY NPI 1770688970

NPI Information

IMAGINE A CHILD'S CAPACITY is a rehabilitation clinic center in Fitchburg, WI. IMAGINE A CHILD'S CAPACITY NPI is 1770688970. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2875 FISH HATCHERY RD
FITCHBURG, WI
ZIP 53713-114
Phone: (608) 204-6242
Fax: (608) 204-6249

The provider's authorized official is David Johnson .
The authorized official title is Executive Director. and has the following contact phone number (608) 316-1127.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 3/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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