Individual
ALYSSA RENEE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
14973 SOUTH AVE, COLUMBIANA, OH 44408-9429
(330) 482-3294
Mailing address
423 TERRA VERDE AVE, COLUMBIANA, OH 44408-1194
(330) 719-4009
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03232997
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH.03232997
OHIO STATE BOARD OF PHARMACY
OH
Enumeration date
08/01/2013
Last updated
08/01/2013
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