Individual
JESSICA SPROUSE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2924 BROOK RD, RICHMOND, VA 23220-1215
(804) 228-5890
Mailing address
2924 BROOK RD, RICHMOND, VA 23220-1215
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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