Individual
MR. MARK ALLEN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3607 N EVERBROOK LANE, MUNCIE, IN 47304
(765) 741-8390
(765) 741-8219
Mailing address
3607 N EVERBROOK LANE, MUNCIE, IN 47304
(765) 741-8390
(765) 741-8219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IN05004768A
IN
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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