Provider Demographics
NPI:1124107131
Name:BRIGHT, JO LIETA WYNETTE (DC)
Entity type:Individual
Prefix:DR
First Name:JO LIETA
Middle Name:WYNETTE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:DC
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Other - First Name:
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Mailing Address - Street 1:2 S COO Y YAH ST
Mailing Address - Street 2:ST 4
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-4636
Mailing Address - Country:US
Mailing Address - Phone:918-825-2525
Mailing Address - Fax:918-825-2615
Practice Address - Street 1:2 S COO Y YAH ST
Practice Address - Street 2:ST 4
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-4636
Practice Address - Country:US
Practice Address - Phone:918-825-2525
Practice Address - Fax:918-825-2615
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor