Individual
MRS. ELEANOR MARIE WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3589
(304) 766-3793
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3589
(304) 766-3793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002787
WV
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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