Individual
EMILY GRACE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 S COLLEGE ST FL 12, CHARLOTTE, NC 28244-0002
(704) 489-3010
Mailing address
5960 FAIRVIEW RD STE 500, CHARLOTTE, NC 28210-3113
(704) 918-1934
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-15122
NC
Other
Enumeration date
04/29/2024
Last updated
02/18/2025
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