Individual
BENJAMIN ANTHONY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2555 UNIVERSITY DR, FAIRBORN, OH 45324-6255
(937) 775-7792
Mailing address
2555 UNIVERSITY DR, FAIRBORN, OH 45324-6255
(937) 775-7792
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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