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Individual

DR. CODY DOUGLAS WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Mailing address
5360 28TH AVE S APT 206, FARGO, ND 58104-5935
(269) 240-3162

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH6211
ND

Other

Enumeration date
06/21/2020
Last updated
06/21/2020
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