Individual
BRETT WISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
636 EASTERN AVE, BELLEFONTAINE, OH 43311-2614
(937) 407-2835
Mailing address
636 EASTERN AVE, BELLEFONTAINE, OH 43311-2614
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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