MEDICARE: MARIE ANTONETTE WRIGHT-COZART

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	171W00000X	Contractor	1823245	OH

General Provider Information

NPI Number	:	1063016749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE ANTONETTE WRIGHT-COZART

Provider Business Mailing Address
First Line	:	4926 MONTICELLO BLVD
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	OH
Zip	:	44143-2848
Country	:	US
Telephone Number	:	216-326-1377
Fax Number	:

Provider Business Practice Location Address
First Line	:	4926 MONTICELLO BLVD
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	OH
Zip	:	44143-2848
Country	:	US
Telephone Number	:	216-326-1377
Fax Number	:

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

Provider Enumeration Date	:	11/24/2020
Last Update Date	:	11/24/2020

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Directions to “ MARIE ANTONETTE WRIGHT-COZART ” Practice Location

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