Individual
MRS. LEAH WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
1901 RANDOLPH RD, CHARLOTTE, NC 28207-1101
(704) 316-2000
Mailing address
1901 RANDOLPH RD, CHARLOTTE, NC 28207-1101
(704) 316-2000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1460
NC
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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