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1922547215
ALISSA NISWONGER
FORT WAYNE, IN
NPI
1922547215
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: OH 005105)
Enumeration Date
2017-02-20
Last Update Date
2024-12-04
Business Address
ALISSA NISWONGER MS, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 219-861-9144
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Mailing Address
ALISSA NISWONGER MS, LAT, ATC
1000 W FOUNTAIN GROVE DR
BRYAN, OH 43506
Phone number: 419-636-4536
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