Individual
JEFFREY J. WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
1501 W CHISHOLM ST, ALPENA, MI 49707-1401
(989) 356-7390
(989) 340-1214
Mailing address
1014 SIXTH ST, STE. 103, TRAVERSE CITY, MI 49684-2381
(989) 340-1211
(989) 340-1214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003807
MI
Other
Enumeration date
07/04/2006
Last updated
07/25/2014
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