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Individual

BRIAN S WISMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, KT

Contact information

Practice address
770 CASTLEWOOD LN, DEERFIELD, IL 60015-3971
(847) 236-9499
(847) 236-1107
Mailing address
770 CASTLEWOOD LN, DEERFIELD, IL 60015-3971
(847) 236-9499
(847) 236-1107

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IL

Other

Enumeration date
03/08/2007
Last updated
07/08/2007
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