Provider Demographics
NPI:1457374977
Name:WRIGHT, LISA L (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEBER
Mailing Address - State:UT
Mailing Address - Zip Code:84405-9235
Mailing Address - Country:US
Mailing Address - Phone:801-475-4471
Mailing Address - Fax:
Practice Address - Street 1:1580 W ANTELOPE DR STE 130A
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1173
Practice Address - Country:US
Practice Address - Phone:801-525-5277
Practice Address - Fax:801-525-5279
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152911-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy