Individual
KRISTIN RENEE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(517) 230-6357
Mailing address
2317 BEATRICE DR NE, GRAND RAPIDS, MI 49505-3980
(517) 230-6357
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201006408
MI
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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