MEDICARE: VICTORIA WRIGHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1467122325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA WRIGHT

Provider Business Mailing Address
First Line	:	28087 ANGELA DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-4937
Country	:	US
Telephone Number	:	440-420-9052
Fax Number	:

Provider Business Practice Location Address
First Line	:	28087 ANGELA DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-4937
Country	:	US
Telephone Number	:	440-420-9052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	08/02/2022

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Directions to “ VICTORIA WRIGHT ” Practice Location

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