Individual
DR. JILLIAN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, LAT, ATC
Contact information
Practice address
1120 20TH ST NW, WASHINGTON, DC 20036-3406
(202) 416-2110
Mailing address
2527 REMINGTON ST, FALLS CHURCH, VA 22046-1930
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305216542
VA
225100000X
Physical Therapist
Primary
CP031972T
DC
2255A2300X
Athletic Trainer
0126004043
VA
Other
Enumeration date
11/27/2023
Last updated
06/10/2024
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