Provider Demographics
NPI:1639624042
Name:WISE HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:WISE HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:THEO
Authorized Official - Last Name:WISE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:754-900-8074
Mailing Address - Street 1:701 E BROWARD BLVD STE D
Mailing Address - Street 2:1
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2022
Mailing Address - Country:US
Mailing Address - Phone:754-900-8074
Mailing Address - Fax:
Practice Address - Street 1:701 E BROWARD BLVD STE D
Practice Address - Street 2:1
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2022
Practice Address - Country:US
Practice Address - Phone:754-900-8074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty