Individual
CONNOR WISNIEWSKI-TOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
(318) 222-8893
Mailing address
663 JORDAN ST, SHREVEPORT, LA 71101-4748
(318) 222-8892
(318) 222-8893
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11682R
LA
225100000X
Physical Therapist
P23108
NC
225100000X
Physical Therapist
PT38752
FL
Other
Enumeration date
08/09/2022
Last updated
11/14/2024
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