Individual
JEFFREY JOHN WISINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 758-0106
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
87924
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
OS020477
PA
Other
Enumeration date
05/04/2016
Last updated
03/06/2023
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