Individual
MICHELLE ANNE WISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
17129 SOUTH HARLEM, SUITE B3, TINLEY PARK, IL 60477
(708) 253-6510
Mailing address
17129 SOUTH HARLEM, SUITE B3, TINLEY PARK, IL 60477
(708) 253-6510
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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