Individual
MRS. LISA MARIE WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C.
Contact information
Practice address
4775 KNIGHTSBRIDGE BLVD, SUITE 207, COLUMBUS, OH 43214-4313
(614) 442-5557
Mailing address
3497 PATCON WAY, HILLIARD, OH 43026-3863
(614) 771-5760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.002771
OH
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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