Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1154850600 |
---|---|
Provider Name | Ms. Amy Irene Wright |
First Address | Edmond, OK 73083-2144 |
Second Address | Edmond, OK 73034-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 08/06/2017 |