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1497445860
MATTHEW LEE WISE
LOUISA, KY
NPI
1497445860
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 273260)
Enumeration Date
2023-05-10
Last Update Date
2023-05-10
Business Address
MATTHEW LEE WISE
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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Mailing Address
MATTHEW LEE WISE
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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