Individual
NINA MICHELLE WISENBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO
Contact information
Practice address
1302 N STANTON ST, EL PASO, TX 79902-4122
(915) 532-4444
Mailing address
1302 N. STANTON ST., 1302 N. STANTON ST, EL PASO, TX 79902
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
TX
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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