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Individual

JEFFREY WISEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
1 YMCA WAY STE B, HAMPTON, VA 23669-3963
(757) 736-2676
Mailing address
1 YMCA WAY STE B, HAMPTON, VA 23669-3963
(757) 736-2676

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002647
VA

Other

Enumeration date
05/05/2020
Last updated
05/05/2020
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