Individual
MR. DAVID WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
728 WISCONSIN ST, LAKE GENEVA, WI 53147-1826
(126) 221-5908
Mailing address
N2454 BANNECKER DR, BURLINGTON, WI 53105-9029
(126) 241-2534
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
225762-30
WI
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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