BRENT T VISSAT

KENOSHA, WI
NPI1487966305
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  2576-23)
Enumeration Date2010-07-08
Last Update Date2021-12-29
Business Address
Mr. BRENT T VISSAT PA-C
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number: 262-948-5600
Mailing Address
Mr. BRENT T VISSAT PA-C
3301 W FOREST HOME AVE
MILWAUKEE, WI 53215-2843
Phone number: 262-948-5600