Individual
JACOB WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 VETERANS MEMORIAL BLVD, METAIRIE, LA 70005-2937
(504) 900-1411
Mailing address
612 VETERANS MEMORIAL BLVD, METAIRIE, LA 70005-2937
(504) 900-1411
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
LA
Other
Enumeration date
05/09/2026
Last updated
05/09/2026
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