Individual
JOHN RICHARD WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSCS, ACSM-EP
Contact information
Practice address
1501 LAKESIDE DR, LYNCHBURG, VA 24501-3113
(870) 613-3355
Mailing address
952 LINDSAY ST, LYNCHBURG, VA 24502-1501
(870) 613-3355
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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