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Individual
DR. REBECCA MILLER WISE
Active
Individual
DR. REBECCA MILLER WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD, MED
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP440472
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760736870
LECOM MTM SERVICES NPI
PA
Enumeration date
04/09/2007
Last updated
10/29/2012
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