Individual
DR. JONATHAN BIRCHLER WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT, MS, ATC
Contact information
Practice address
3800 AMERICAN BLVD W # 200, BLOOMINGTON, MN 55431-4420
(952) 831-8742
Mailing address
13643 BRICK PATH, ROSEMOUNT, MN 55068-2471
(608) 963-9526
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
12745
MN
2255A2300X
Athletic Trainer
36002462A
IN
Other
Enumeration date
11/11/2015
Last updated
07/06/2022
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