Individual
BARRY HOWARD WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
13686 VAN NUYS BLVD, PACOIMA, CA 91331-3616
(818) 896-1104
(818) 896-7299
Mailing address
13686 VAN NUYS BLVD, PACOIMA, CA 91331-3616
(818) 896-1104
(818) 896-7299
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22779
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA327640
—
CA
Enumeration date
03/20/2007
Last updated
07/08/2007
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