Individual
REGIS WILLIAM VISCONTI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
104 FIELDSTONE DR, GLENSHAW, PA 15116-1306
(412) 527-9753
Mailing address
104 FIELDSTONE DR, GLENSHAW, PA 15116-1306
(412) 527-9753
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT005296
PA
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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