Individual
MICHAEL WISNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1142 W GUADALUPE RD, MESA, AZ 85210-7602
(480) 345-7367
Mailing address
1142 W GUADALUPE RD, MESA, AZ 85210-7602
(480) 345-7367
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13277
AZ
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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