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Individual

LAURA WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
118 E 2ND ST, ERIE, PA 16507-1502
(814) 139-2051
Mailing address
118 E 2ND ST, ERIE, PA 16507-1502
(814) 139-2051

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054709
PA

Other

Enumeration date
12/14/2010
Last updated
08/16/2023
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