Individual
NICHOLAS GUY WISMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LMP
Contact information
Practice address
6881 S HOLLY CIR, 207, CENTENNIAL, CO 80112-1145
(303) 301-4185
Mailing address
3714 BUCKNELL DR, HIGHLANDS RANCH, CO 80129-4397
(303) 301-4185
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC60099399
WA
171100000X
Acupuncturist
Primary
ACU 1492
CO
225700000X
Massage Therapist
MA00023357
WA
225700000X
Massage Therapist
MT-4817
CO
Other
Enumeration date
08/16/2009
Last updated
09/13/2012
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