Individual
MRS. LISA ANN VISCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
13 COOPERSTOWN CT, PHOENIX, MD 21131-1328
(410) 967-4865
Mailing address
13 COOPERSTOWN CT, PHOENIX, MD 21131-1328
(410) 967-4865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17696
MD
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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