Individual
DR. MATTHEW JOHN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
190 SPRING DR, SAINT CHARLES, MO 63303-3255
(636) 946-0799
(314) 205-1508
Mailing address
14324 S OUTER 40, CHESTERFIELD, MO 63017-5710
(314) 208-8858
(314) 205-1508
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2004017456
MO
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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