Individual
JASON PATRICK WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
07978
OH
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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