Provider Demographics
NPI:1053184663
Name:VISCONTE, DENISE (DACM, MAOM, MSC CHM)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:VISCONTE
Suffix:
Gender:F
Credentials:DACM, MAOM, MSC CHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-4956
Mailing Address - Country:US
Mailing Address - Phone:608-704-9886
Mailing Address - Fax:
Practice Address - Street 1:1015 N 8TH ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-4956
Practice Address - Country:US
Practice Address - Phone:608-704-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2011-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist