Provider Demographics
NPI:1669820718
Name:WISE BIRTH CHOICES LLC
Entity Type:Organization
Organization Name:WISE BIRTH CHOICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DILLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-754-9551
Mailing Address - Street 1:15 FLETCHER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1404
Mailing Address - Country:US
Mailing Address - Phone:732-754-9551
Mailing Address - Fax:
Practice Address - Street 1:15 FLETCHER DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1404
Practice Address - Country:US
Practice Address - Phone:732-754-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
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