Individual
KERRI WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
400 SUMMIT BLVD, BROOMFIELD, CO 80021-8300
(303) 466-2422
Mailing address
1260 KALMIA AVE APT 12, BOULDER, CO 80304-1830
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12739
CO
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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