Individual
BRIDGET ALISE WISELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ATC
Contact information
Practice address
308 ROLLING CREEK RD, SWARTHMORE, PA 19081-2633
(610) 543-7766
Mailing address
308 ROLLING CREEK RD, SWARTHMORE, PA 19081-2633
(610) 543-7766
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
J30000402
DE
2255A2300X
Athletic Trainer
Primary
RT004234
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
DE
Enumeration date
12/11/2011
Last updated
09/04/2013
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