Individual
BRIAN PAUL WISOWATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2597 SCHOENERSVILLE RD STE 100, BETHLEHEM, PA 18017-7325
(610) 402-8900
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 884-4500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA061947
PA
363A00000X
Physician Assistant
PA9112585
FL
Other
Enumeration date
09/25/2019
Last updated
12/21/2020
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