STUART R WISE

PROVO, UT
NPI1154582443
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology
(Licence: UT  161107-1205)
Enumeration Date2008-06-19
Last Update Date2008-06-19
Business Address
Dr. STUART R WISE M.D.
1579 WILLOW LN
PROVO, UT 84604-2804
Phone number: 801-722-4678
Mailing Address
Dr. STUART R WISE M.D.
1579 WILLOW LN
PROVO, UT 84604-2804
Phone number: 801-722-4678