Provider Demographics
NPI:1497057467
Name:WRIGHT, M JENNIFER (LAC)
Entity Type:Individual
Prefix:
First Name:M JENNIFER
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 YOUNGFIELD ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1045
Mailing Address - Country:US
Mailing Address - Phone:303-475-8522
Mailing Address - Fax:303-200-4917
Practice Address - Street 1:2500 YOUNGFIELD ST
Practice Address - Street 2:SUITE 4
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1045
Practice Address - Country:US
Practice Address - Phone:303-475-8522
Practice Address - Fax:303-200-4917
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COACU-604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist