| Organization Name: | THE ARC OF FOND DU LAC |
| NPI Number: | 1003993809 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROL L HANDY (BILLING MANAGER) |
| Mailing Address: | 500 N Park Ave Fond Du Lac |
| State: | WI US |
| Postal Code: | 549351943 |
| Phone Number: | 9209298858 |
| Fax Number: | 9209233038 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 5225-024 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |