Individual
MRS. PATRICIA A WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 OLIVER DR, RINGGOLD, VA 24586-5704
(434) 709-6478
Mailing address
50 OLIVER DR, RINGGOLD, VA 24586-5704
(434) 709-6478
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
WNN-1804
VA
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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