Individual
CAROLETT WISE X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13885 HEDGEWOOD DR, WOODBRIDGE, VA 22193-7928
(571) 212-6176
Mailing address
13885 HEDGEWOOD DR, WOODBRIDGE, VA 22193-7928
(571) 212-6176
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1201079134
VA
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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