Individual
MR. MATTHEW WISWESSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
256 HOWARD AVE, ROCHELLE PARK, NJ 07662-3421
(201) 519-6994
Mailing address
256 HOWARD AVE, ROCHELLE PARK, NJ 07662-3421
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00165600
NJ
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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