Individual
MADISON WISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4626 HIGHWAY 58, CHATTANOOGA, TN 37416-3013
(423) 553-7972
(423) 553-7973
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 238-8930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2480
TN
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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