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Individual

MS. LYNN MARIE WISNIEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1666 ROUTE 12, GALES FERRY, CT 06360
(860) 464-1949
(860) 464-3118
Mailing address
150 OTROBANDO AVE, NORWICH, CT 06360
(860) 889-1948
(860) 889-1101

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004210
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080004210CT01
BCBS
CT
01
080004210CT02
ANTHEM BCBS
CT
01
080004210CT022
ANTHEM BCBS
CT
01
080004210CT024
ANTHEM BCBS
CT
01
080004210CT23
ANTHEM BCBS
CT
Enumeration date
08/07/2006
Last updated
07/08/2007
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