Individual
MISS LESLIE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
616 CHAUCER DR, FLORENCE, SC 29505-3629
(843) 697-9245
Mailing address
616 CHAUCER DR, FLORENCE, SC 29505-3629
(843) 697-9245
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4921
SC
Other
Enumeration date
06/15/2007
Last updated
12/09/2022
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