Diane L Wise Trial

NPI #1962719922 in Marana, Arizona

Provider Information

NPI Number: 1962719922
Entity Type: Individual
Name: Diane L Wise Trial
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Sep 10, 2010
Last Updated: Sep 10, 2010

Practice Location

Address: 12100 N THORNYDALE RD
City: Marana
State: Arizona
ZIP Code: 85658-4755
Phone: (520) 572-6041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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