Individual
TODD ANTHONY WISOCKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11000 EVERBLADES PKWY, ESTERO, FL 33928-9412
(239) 948-7825
(239) 948-2248
Mailing address
16901 COLONY LAKES BLVD, FORT MYERS, FL 33908-9610
(239) 466-5812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1316
FL
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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