Individual
GRANT WISHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 W MCLANE ST, OSCEOLA, IA 50213-1419
(641) 342-1470
Mailing address
PO BOX 461, NEVADA, IA 50201-0461
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
126455
IA
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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