Healthcare Provider Details

I. General information

NPI: 1932141983
Provider Name (Legal Business Name): LINDA KAY WRIGHT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12775 ESCANABA DR SUITE 3
DEWITT MI
48820-8615
US

IV. Provider business mailing address

12775 ESCANABA DR SUITE 3
DEWITT MI
48820-8615
US

V. Phone/Fax

Practice location:
  • Phone: 517-669-8080
  • Fax: 517-669-8070
Mailing address:
  • Phone: 517-669-8080
  • Fax: 517-669-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number3501003233
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: