Individual
CARRIE WISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 N EL CENTRO AVE, LOS ANGELES, CA 90038-3805
(800) 864-5437
Mailing address
6637 FRANKLIN AVE, APT. 10, LOS ANGELES, CA 90028-4760
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/05/2009
Last updated
05/16/2013
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