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General NPI Number Information
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NPI Number | 1295746733
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Entity Type | Individual
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Provider Name | GWEN WRIGHT PAC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 194 W SPROUL RD SUITE 105
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City | SPRINGFIELD
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State | PA
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Zip | 19064-2027
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Country | US
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Telephone | 610-543-3246
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Fax | 610-543-1738
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Provider Business Mailing Address
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Address Line | 2916 ARMSTRONG AVE
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City | SECANE
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State | PA
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Zip | 19018-4636
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Country | US
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Telephone | 610-328-1473
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA002169L
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License Number State | PA
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