Michelle Anne Wisen, PTA

NPI #1538728258 in Tinley Park, Illinois

Provider Information

NPI Number: 1538728258
Entity Type: Individual
Name: Michelle Anne Wisen, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 6, 2019
Last Updated: Jun 6, 2019

Practice Location

Address: 17129 SOUTH HARLEM
Address 2: SUITE B3
City: Tinley Park
State: Illinois
ZIP Code: 60477
Phone: (708) 253-6510

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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