Individual
KATHY SUE WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
302 MIDDLE ST, VAN WERT, OH 45891-1048
(419) 771-0157
Mailing address
11464 HOGHE RD, VAN WERT, OH 45891-9225
(419) 238-2456
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
OH
Other
Enumeration date
05/04/2022
Last updated
05/05/2022
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