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Organization

CHRIS WISMER PT GCFP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHRISTINE F WISMER PT (OWNER)
(505) 231-3361
Entity
Organization

Contact information

Practice address
230 S SAINT FRANCIS DR STE 5, SANTA FE, NM 87501-2456
(505) 231-3361
(505) 989-1740
Mailing address
29 DOMINGO RD, SANTA FE, NM 87508-8256
(505) 231-3361
(505) 466-2707

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1265
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20578521
NM
Enumeration date
02/27/2013
Last updated
02/27/2013
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