Individual
MRS. CANDIDA EVE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
520 E AUGUSTA AVE, AUGUSTA, KS 67010-2100
(316) 775-5491
(316) 775-5442
Mailing address
520 E AUGUSTA AVE, AUGUSTA, KS 67010-2100
(316) 775-5491
(316) 775-5442
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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