Individual
MARY WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2057 CHARLIE HALL BLVD STE C, CHARLESTON, SC 29414-6164
(843) 637-3037
(843) 203-0883
Mailing address
2057 CHARLIE HALL BLVD STE C, CHARLESTON, SC 29414-6164
(843) 637-3037
(843) 203-0883
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12197
SC
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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