Individual
ERIC WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 NW 79TH AVE, TAMARAC, FL 33321-4639
(954) 722-7001
(954) 720-5419
Mailing address
6891 SW 16TH CT, NORTH LAUDERDALE, FL 33068-4309
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OTA10291
FL
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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