Matthew Wiseman

NPI #1184929168 in Provo, Utah

Provider Information

NPI Number: 1184929168
Entity Type: Individual
Name: Matthew Wiseman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Jan 21, 2011
Last Updated: Sep 4, 2020

Practice Location

Address: 445 N UNIVERSITY AVE
City: Provo
State: Utah
ZIP Code: 84601-2863
Phone: (208) 757-0805

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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