Gary A. Wishart, Psy.d., Pllc

NPI #1780948950 in Bristol, Tennessee

Provider Information

NPI Number: 1780948950
Entity Type: Organization
Organization Name: Gary A. Wishart, Psy.d., Pllc
Primary Specialty: Psychologist
Enumeration Date: Jul 2, 2012
Last Updated: Jul 2, 2012

Practice Location

Address: 601 VOLUNTEER PKWY
Address 2: SUITE G
City: Bristol
State: Tennessee
ZIP Code: 37620-3653
Phone: (423) 652-2212

Authorized Official

Name: GARY AUSTIN WISHART, PSY.D.
Title: OWNER
Phone: (423) 652-2212

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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