Individual
MATTHEW S WISHNOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 E MARSHALL ST, RICHMOND, VA 23298-5026
(804) 828-9788
Mailing address
1501 N LARRABEE ST, CHICAGO, IL 60610-1119
(312) 330-1861
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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