| Doctor Name: | ELIZABETH A VISSAT |
| NPI Number: | 1609003508 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | I005-25 |
| Business Practice Address: | 100 15th Ave Ste 180 Lakeshore Medical Clinics South Milwaukee, WI - 531721160 |
| Business Phone Number: | 4147685430 |
| Business Fax Number: | |
| Mailing Address: | 100 15th Ave Ste 180, Lakeshore Medical Clinics SOUTH MILWAUKEE |
| State: | WI |
| Postal Code: | 531721160 |
| Phone Number: | 4147685430 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2009 |
| NPI Last Update Date: | 11/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | I005-25 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |