MEDICARE: MR. JASON A WRIGHT L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	001384-1	NY

General Provider Information

NPI Number	:	1043253552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON A WRIGHT L.AC.

Provider Business Mailing Address
First Line	:	2940 DARLING RD
Second Line	:
City	:	INTERLAKEN
State	:	NY
Zip	:	14847-9748
Country	:	US
Telephone Number	:	315-568-3132
Fax Number	:	315-368-3700

Provider Business Practice Location Address
First Line	:	2360 STATE ROUTE 89
Second Line	:
City	:	SENECA FALLS
State	:	NY
Zip	:	13148-9425
Country	:	US
Telephone Number	:	315-568-3166
Fax Number	:	315-568-3700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/08/2007

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