ALISSA NISWONGER

FORT WAYNE, IN
NPI1922547215
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: OH  005105)
Enumeration Date2017-02-20
Last Update Date2024-12-04
Business Address
ALISSA NISWONGER MS, LAT, ATC
3946 ICE WAY
FORT WAYNE, IN 46805-1018
Phone number: 219-861-9144
Mailing Address
ALISSA NISWONGER MS, LAT, ATC
1000 W FOUNTAIN GROVE DR
BRYAN, OH 43506
Phone number: 419-636-4536