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General NPI Number Information
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NPI Number | 1730184508
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Entity Type | Individual
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Provider Name | TYLER JOSEPH WRIGHT O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 3201 PAXTON ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1340
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Country | US
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Telephone | 717-561-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 859 ORCHARD RD
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City | MANHEIM
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State | PA
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Zip | 17545-9278
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Country | US
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Telephone | 717-665-1311
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001486
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License Number State | PA
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