Individual
DR. JACLYN WISNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
5108 N 22ND ST, OZARK, MO 65721-7637
(501) 339-7267
Mailing address
3811 S WELLER AVE APT A303, SPRINGFIELD, MO 65804-5274
(501) 339-7267
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
2021029279
MO
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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