Individual
LARYSSA LUCILLE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 SAWDUST RD, SPRING, TX 77380-2272
(281) 216-2313
Mailing address
130 SAWDUST RD, SPRING, TX 77380-2272
(281) 216-2313
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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