Organization
ORTHOPAEDICS SPORTS & WORKERS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ROYCE WISNER MD (PRESIDENT)
(209) 368-7777
Entity
Organization
Contact information
Practice address
804 MILL ST, RENO, NV 89502-1421
(775) 657-8171
(775) 657-8202
Mailing address
621 S HAM LN STE A, LODI, CA 95242-3533
(209) 368-7777
(209) 368-7778
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/25/2019
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