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Individual

KATIE WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
200 MEMORIAL DR, MONDOVI, WI 54755-1325
(715) 926-6123
Mailing address
1804 SUN VISTA CT, EAU CLAIRE, WI 54703-6187

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4660-027
WI

Other

Enumeration date
09/09/2014
Last updated
09/09/2014
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