Individual
AGNES ANNA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 E WASHINGTON ST, MEDINA, OH 44256-2126
(330) 722-3781
Mailing address
700 E WASHINGTON ST, MEDINA, OH 44256-2126
(330) 722-3781
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10779
OH
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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