Provider Demographics
NPI:1790054385
Name:WRIGHT, MICHELLE L (MSAOM, LAC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512-0302
Mailing Address - Country:US
Mailing Address - Phone:585-203-0913
Mailing Address - Fax:
Practice Address - Street 1:19 MILL STREET
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:NY
Practice Address - Zip Code:14512
Practice Address - Country:US
Practice Address - Phone:585-203-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004374171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist