Individual
DR. JOHN H WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
509 N. AVENUE G, CROWLEY, LA 70526
(337) 783-1280
Mailing address
PO BOX 630, CROWLEY, LA 70526
(337) 783-1280
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
812148T
LA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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