# DR. JONATHAN BIRCHLER WISE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1346613437
- **Gender:** Man
- **Credential:** DPT, PT, MS, ATC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | 12745 | MN | Yes |
| 2255A2300X | Athletic Trainer | 36002462A | IN | — |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 07/06/2022