SUSAN CAROL WISE

AUGUSTA, GA
NPI1275875163
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: GA  OTA 000112)
Enumeration Date2013-03-19
Last Update Date2013-03-19
Business Address
-- SUSAN CAROL WISE COTA/L
1120 15TH ST # 2902
AUGUSTA, GA 30912-0004
Phone number: 706-721-5223
Mailing Address
-- SUSAN CAROL WISE COTA/L
1446 HARPER ST
AUGUSTA, GA 30912-0012
Phone number: 706-721-5223