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1073068722
MARISSA BACON
KENOSHA, WI
NPI
1073068722
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 13544-24)
Enumeration Date
2016-08-23
Last Update Date
2021-11-19
Business Address
Ms. MARISSA BACON PT, DPT
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number: 262-948-3600
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Mailing Address
Ms. MARISSA BACON PT, DPT
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number:
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