Individual
STACY RISCHETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1268 2ND AVE, CUMBERLAND, WI 54829-7210
(715) 822-4418
Mailing address
PO BOX 362, CUMBERLAND, WI 54829-0362
(715) 822-4418
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
958-55
WI
225700000X
Massage Therapist
10139-146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
958-55
WI LICENSE NUMBER
WI
Enumeration date
08/29/2019
Last updated
08/29/2019
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