Organization
RICHARD G WISE DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G WISE D.O. (PRESIDENT)
(330) 542-2881
Entity
Organization
Contact information
Practice address
11 SYCAMORE DRIVE, NEW MIDDLETOWN, OH 44442
(330) 542-2881
(330) 542-0074
Mailing address
PO BOX 272, NEW MIDDLETOWN, OH 44442-0272
(330) 542-2881
(330) 542-0074
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
34003728
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0598769
—
OH
Enumeration date
10/30/2007
Last updated
11/08/2007
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