Individual
DR. BRUCE S. BENCRISCUTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
612 N CHURCH ST, WATERTOWN, WI 53098-2111
(920) 261-1226
(920) 261-1435
Mailing address
612 N CHURCH ST, WATERTOWN, WI 53098-2111
(920) 261-1226
(920) 261-1435
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1636-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
525007
DEAN CARE HMO
WI
01
—
75609
WPS
WI
Enumeration date
10/18/2006
Last updated
07/08/2007
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