Individual
SUE RANETTE WISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
331 HOSPITAL DR, SUITE D, LEBANON, MO 65536-9217
(417) 533-6315
(417) 533-6320
Mailing address
70 OAK HILL DR, STRAFFORD, MO 65757-7864
(417) 859-6327
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2007001236
MO
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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