Provider Demographics
NPI:1659491868
Name:WRIGHT, BILL (LAC)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18568 RIVER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-9557
Mailing Address - Country:US
Mailing Address - Phone:530-346-7735
Mailing Address - Fax:
Practice Address - Street 1:251 AUBURN RAVINE RD
Practice Address - Street 2:SUITE #205
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3719
Practice Address - Country:US
Practice Address - Phone:530-886-8927
Practice Address - Fax:530-887-8077
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8232171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist