Individual
ANN MARIE NICOLE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2335 VISTA WAY, OCEANSIDE, CA 92054-5663
(760) 547-2666
Mailing address
512 OLYMPIC WAY APT H, OCEANSIDE, CA 92058-7920
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
53978
CA
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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