| Jared M Wise, PT | |
|
1401 E 12th St, Mendota, IL 61342-9216 | |
| (815) 539-1409 | |
| Not Available |
| Full Name | Jared M Wise |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1401 E 12th St, Mendota, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174888275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070017309 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jared M Wise, PT 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-1409 | Jared M Wise, PT 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-1409 |
Franklin J Duro, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1401 E 12th St, Mendota, IL 61342 Phone: 815-539-1409 | |
Reid Baltikauski, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1401 E 12th St, Mendota, IL 61342 Phone: 815-539-1409 |