Provider Demographics
NPI:1508630450
Name:WRIGHT, LISA MARIE (CPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 WILCREST CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-2650
Mailing Address - Country:US
Mailing Address - Phone:803-610-9197
Mailing Address - Fax:
Practice Address - Street 1:829 WILCREST CT
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-2650
Practice Address - Country:US
Practice Address - Phone:803-610-9197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCZ6J4X3R6246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy