Individual
BEVERLY LYLE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 INTERNATIONAL CIR STE 100, HUNT VALLEY, MD 21030-1387
(410) 667-7200
Mailing address
307 INTERNATIONAL CIR STE 100, HUNT VALLEY, MD 21030-1387
(410) 667-7200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002454
GA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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