Individual
MARY RAGAN WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 TOM HUNTER RD, CHARLOTTE, NC 28213-5511
(704) 589-5136
Mailing address
221 N LOCUST ST, FLOYD, VA 24091-2106
(540) 250-7888
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16342
NC
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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