Patricia Diane Wise, PA
Physician Assistant in Bryan, OH. Individual provider (NPI-1).
NPI number1720388481
StatusActive
Last updated in NPPESJan 2, 2024
Details
- NPI
- 1720388481
- Entity type
- Individual (NPI-1)
- Name
- Ms. Patricia Diane Wise
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 28, 2010
- Certification date
- Jan 2, 2024
- Last updated
- Jan 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 50.007054RX | OH | Yes |
Practice location
433 W High StBryan, OH 43506-1690
Phone 419-636-1131 · Fax 419-636-3100
Mailing address
433 W High StBryan, OH 43506-1690
Phone 419-636-1131 · Fax 419-636-3100
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