Individual
DR. NICHOLAS ROBERT WISSINK
Active
Individual
DR. NICHOLAS ROBERT WISSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, MATCS,CSCS,
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2398
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025511800
—
NE
05
—
10025511900
—
NE
01
—
36539
BCBS
NE
Enumeration date
01/06/2006
Last updated
02/07/2023
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