Individual
JERI L WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1701 N GREEN VALLEY PKWY, BLDG 8, STE. B, HENDERSON, NV 89074-5885
(702) 998-3333
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1045
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003402035
—
NV
Enumeration date
06/02/2006
Last updated
08/06/2015
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