MEDICARE: H. THERESA WRIGHT LDN

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	133V00000X	Registered Dietitian	DN000663	PA

General Provider Information

NPI Number	:	1336406982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	H. THERESA WRIGHT LDN

Provider Business Mailing Address
First Line	:	2500 DEKALB PIKE
Second Line	:	SUITE 200
City	:	EAST NORRITON
State	:	PA
Zip	:	19401-2007
Country	:	US
Telephone Number	:	610-275-3699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 DEKALB PIKE
Second Line	:	SUITE 200
City	:	EAST NORRITON
State	:	PA
Zip	:	19401-2007
Country	:	US
Telephone Number	:	610-275-3699
Fax Number	:

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

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	04/20/2012

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