MEDICARE: DEYONCA R WRIGHT

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	246RP1900X	Phlebotomy Technician		OH

General Provider Information

NPI Number	:	1487365409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEYONCA R WRIGHT

Provider Business Mailing Address
First Line	:	PO BOX 910
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43216-0910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 LAWNVIEW AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-1443
Country	:	US
Telephone Number	:	567-395-7740
Fax Number	:

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

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	12/09/2022

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Directions to “ DEYONCA R WRIGHT ” Practice Location

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