Individual
JULIE M WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
RIVERVIEW PSYCHIATRIC CENTER, AUGUSTA, ME 04330
(207) 624-3900
Mailing address
73 HENNESSEY AVE, BRUNSWICK, ME 04011-2839
(207) 798-4089
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA674
ME
Other
Enumeration date
07/02/2006
Last updated
07/08/2007
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