MATTHEW LEE WISE

LOUISA, KY
NPI1497445860
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY  273260)
Enumeration Date2023-05-10
Last Update Date2023-05-10
Business Address
MATTHEW LEE WISE
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
Mailing Address
MATTHEW LEE WISE
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938