Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 5601001639 | MI |
NPI | 1093767311 |
---|---|
Provider Name | Mrs. Joy Marie Wisser |
First Address | Richland, MI 49083-9735 |
Second Address | Kalamazoo, MI 49001-4111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 28/11/2017 |