Provider Demographics
NPI:1104408053
Name:WRIGHT, KATELYN PATON (BS)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:PATON
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14899 DOSTER RD
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-9143
Mailing Address - Country:US
Mailing Address - Phone:269-716-9628
Mailing Address - Fax:
Practice Address - Street 1:14899 DOSTER RD
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-9143
Practice Address - Country:US
Practice Address - Phone:269-716-9628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
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