Individual
BRENDA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1380 BARSTOW RD, BARSTOW, CA 92311-4944
(760) 252-3502
Mailing address
1380 BARSTOW RD, BARSTOW, CA 92311-4944
(760) 252-3502
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH31540
CA
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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