| NPI | 1558099507 |
|---|---|
| Other Name | CONNOR WISMIEWSKI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11682R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT38752) |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2023-10-19 |