Individual
IAN LEWIS WISSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
5393 S CALLE SANTA CRUZ STE 107, TUCSON, AZ 85706-3556
(520) 225-0129
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
(866) 370-8206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
033933
AZ
225100000X
Physical Therapist
049084
NY
Other
Enumeration date
08/12/2022
Last updated
12/11/2024
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