Individual
DR. LANCE REED WISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000
(623) 537-6014
Mailing address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
(623) 572-3454
(623) 572-3449
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0568
AZ
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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