| Equimotion, Inc | |
|
10750 Gage Ln Soldiers Grove WI 54655-8564 | |
| (608) 632-4459 | |
| (608) 638-7429 |
| Full Name | Equimotion, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10750 Gage Ln, Soldiers Grove, Wisconsin |
| Authorized Official Name and Position | Katherine E Burke (OWNER) |
| Authorized Official Contact | 6086324459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Equimotion, Inc 10750 Gage Ln Soldiers Grove WI 54655-8564 Ph: (608) 632-4459 | Equimotion, Inc 10750 Gage Ln Soldiers Grove WI 54655-8564 Ph: (608) 632-4459 |
| NPI Number | 1033543798 |
|---|---|
| Provider Enumeration Date | 08/29/2013 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033543798 | NPI | - | NPPES |
| 1821362831 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 15790-131 (Wisconsin) | Primary |
Katrina M. Johnson, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Passive Sun Drive, Soldiers Grove, WI 54655 Phone: 608-553-0279 |