Provider Demographics
NPI:1255388153
Name:VISCO, NANCY ANNE (ATC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANNE
Last Name:VISCO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:78 SANER RD
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-1409
Mailing Address - Country:US
Mailing Address - Phone:860-295-1393
Mailing Address - Fax:
Practice Address - Street 1:14 JONES HOLLOW RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447-1448
Practice Address - Country:US
Practice Address - Phone:860-295-8188
Practice Address - Fax:860-295-8976
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer