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Individual

DR. JAMES BLAKE WISEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD.

Contact information

Practice address
34 US HIGHWAY 68 E UNIT A, BENTON, KY 42025-8336
(270) 703-2529
Mailing address
PO BOX 766, BENTON, KY 42025-0766

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016583
KY

Other

Enumeration date
03/26/2020
Last updated
03/26/2020
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