Organization
JONATHAN T WISEMAN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WISEMAN DO (PHYSICIAN)
(856) 761-0766
Entity
Organization
Contact information
Practice address
129 BRIDGEBORO ST, RIVERSIDE, NJ 08075-3201
(856) 461-0766
(215) 523-9281
Mailing address
129 BRIDGEBORO ST, RIVERSIDE, NJ 08075-3201
(856) 461-0766
(215) 523-9281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
01/07/2011
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