Individual
DR. MATTHEW TYLER WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3200 DEVINE ST, SUITE 101, COLUMBIA, SC 29205-1891
(803) 851-5450
Mailing address
3200 DEVINE ST, SUITE 101, COLUMBIA, SC 29205-1891
(803) 851-5450
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3923
SC
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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