Healthcare Provider Details

I. General information

NPI: 1619893211
Provider Name (Legal Business Name): TIANNA WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S 20TH AVE
SAFFORD AZ
85546-3322
US

IV. Provider business mailing address

755 S 20TH AVE
SAFFORD AZ
85546-3322
US

V. Phone/Fax

Practice location:
  • Phone: 928-348-0105
  • Fax: 928-348-0109
Mailing address:
  • Phone: 928-348-0105
  • Fax: 928-348-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberLDO-003492
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: