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General NPI Number Information
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NPI Number | 1083838304
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Entity Type | Individual
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Provider Name | RACHEL BERNADETTE WRIGHT LMT
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Gender | Female
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 1035 GREEN ST SE
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City | CONYERS
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State | GA
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Zip | 30012-5466
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Country | US
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Telephone | 770-922-7775
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Fax | 770-922-7775
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Provider Business Mailing Address
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Address Line | 1449 CHERRY HILL RD SW
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City | CONYERS
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State | GA
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Zip | 30094-6822
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Country | US
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Telephone | 678-446-6246
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60393
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License Number State | FL
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