Organization
EQUIMOTION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE E BURKE SAC (OWNER)
(608) 632-4459
Entity
Organization
Contact information
Practice address
10750 GAGE LN, SOLDIERS GROVE, WI 54655-8564
(608) 632-4459
(608) 638-7429
Mailing address
10750 GAGE LN, SOLDIERS GROVE, WI 54655-8564
(608) 632-4459
(608) 638-7429
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
15790-131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821362831
—
WI
Enumeration date
08/29/2013
Last updated
08/29/2013
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