Individual
JEFFREY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 RESEARCH BLVD STE 109, ROCKVILLE, MD 20850-3215
(301) 337-6921
Mailing address
9042 WALTHAM WOODS RD APT C, PARKVILLE, MD 21234-2567
(443) 752-6874
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5591
MD
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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