Individual
DANIEL THOMAS WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
14307 JARRETTSVILLE PIKE, PHOENIX, MD 21131-1763
(410) 592-7300
(410) 666-0348
Mailing address
PO BOX 38, 14307 JARRETTSVILLE PIKE, PHOENIX, MD 21131-0038
(410) 592-7300
(410) 666-0348
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C004959
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192539
COVENTRY HEALTH INSURANCE
MD
01
—
LY34
CAREFIRST-BLUE CROSS
MD
01
—
R130
FEDERAL-CAREFIRST
MD
Enumeration date
03/26/2007
Last updated
07/08/2007
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