MEDICARE: PROF. CYNTHIA B WRIGHT PHD, RD, CD

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	2363350-4901	UT

General Provider Information

NPI Number	:	1598992661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. CYNTHIA B WRIGHT PHD, RD, CD

Provider Business Mailing Address
First Line	:	1333 N MAIN ST
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-9314
Country	:	US
Telephone Number	:	435-868-5576
Fax Number	:	435-868-7045

Provider Business Practice Location Address
First Line	:	1333 N MAIN ST
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84721-9314
Country	:	US
Telephone Number	:	435-868-5576
Fax Number	:	435-868-7045

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

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	06/16/2009

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