Individual
CODY WISNIESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2108 TAYLOR AVE STE 1100, NORFOLK, NE 68701-4642
(402) 371-7545
Mailing address
1201 CHAROLAIS DR, NORFOLK, NE 68701-2549
(402) 380-4827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3966
NE
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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