Individual
MASON ROBERT WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
453 W 10TH AVE, COLUMBUS, OH 43210-2205
(614) 292-6446
Mailing address
7759 DERBYSHIRE CT, LIBERTY TOWNSHIP, OH 45044-9028
(513) 759-5315
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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