Individual
MEGAN LYNN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
189 MONICA BLVD, LYNCHBURG, VA 24502-2213
(434) 270-0191
Mailing address
299 WILDWOOD DR, LYNCHBURG, VA 24502-5627
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603332
VA
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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