Individual
JILL WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013944
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501013944
MICHIGAN LICENSE
MI
Enumeration date
07/21/2015
Last updated
07/21/2015
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