Provider Demographics
NPI:1639740699
Name:WRIGHT, DAVID (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128-1530
Mailing Address - Country:US
Mailing Address - Phone:816-516-3822
Mailing Address - Fax:
Practice Address - Street 1:3033 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-1530
Practice Address - Country:US
Practice Address - Phone:816-516-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician