Most Relevant Information
Provider Data
| NPI Number: | 1003241662 |
| Provider Name: | TARA LYNN WISE D.P.T. |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT010877L |
Most Important Dates
| Enumeration Date: | 09/13/2013 |
| Last Updated: | 09/13/2013 |
Provider Practice Location
347 N OAK ST
MOUNT CARMEL
PA
178511427
Practice Location Phone/Fax
| Phone: | 5706444485 |
| Fax: |
Provider Mailing Location
347 N OAK ST
MOUNT CARMEL
PA
178511427
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |