Individual
MR. GARY MARK WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
470 SAFFORD AVE W, THOMASVILLE, AL 36784-3112
(334) 636-9809
(334) 636-9807
Mailing address
470 SAFFORD AVE W, THOMASVILLE, AL 36784-3112
(334) 636-9809
(334) 636-9807
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9084
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118794
NABP NUMBER
AL
Enumeration date
06/18/2007
Last updated
07/08/2007
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