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1154582443
STUART R WISE
PROVO, UT
NPI
1154582443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology
(Licence: UT 161107-1205)
Enumeration Date
2008-06-19
Last Update Date
2008-06-19
Business Address
Dr. STUART R WISE M.D.
1579 WILLOW LN
PROVO, UT 84604-2804
Phone number: 801-722-4678
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Mailing Address
Dr. STUART R WISE M.D.
1579 WILLOW LN
PROVO, UT 84604-2804
Phone number: 801-722-4678
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