DAVID LEO WISE

POCATELLO, ID
NPI1134259849
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  M-3654)
Enumeration Date2007-03-06
Last Update Date2007-07-09
Business Address
Dr. DAVID LEO WISE M.D.
115 S 15TH AVE
POCATELLO, ID 83201-4068
Phone number: 208-234-0012
Mailing Address
Dr. DAVID LEO WISE M.D.
115 S 15TH AVE
POCATELLO, ID 83201-4068
Phone number: 208-234-0012
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