Provider Demographics
NPI:1154850600
Name:WRIGHT, AMY IRENE
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:IRENE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N BROADWAY UNIT 1494
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-2144
Mailing Address - Country:US
Mailing Address - Phone:1417-438-2723
Mailing Address - Fax:
Practice Address - Street 1:614 MARY LEE LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5421
Practice Address - Country:US
Practice Address - Phone:417-438-2723
Practice Address - Fax:417-438-2723
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath