Individual
LARRY ANDREW WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(762) 408-3500
Mailing address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(762) 408-3500
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD003931
GA
Other
Enumeration date
06/12/2013
Last updated
06/16/2026
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