Healthcare Provider Details

I. General information

NPI: 1962994251
Provider Name (Legal Business Name): HEATHER ANN WRIGHT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 DAYTON XENIA RD
BEAVERCREEK OH
45434-6393
US

IV. Provider business mailing address

3060 DAYTON XENIA RD
BEAVERCREEK OH
45434-6393
US

V. Phone/Fax

Practice location:
  • Phone: 937-427-2225
  • Fax: 937-405-1078
Mailing address:
  • Phone: 937-427-2225
  • Fax: 937-405-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.017452
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: