MEDICARE: JILLIAN 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	225700000X	Massage Therapist	MT137777	TX

General Provider Information

NPI Number	:	1699465690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN WRIGHT

Provider Business Mailing Address
First Line	:	7811 SPRINGBERRY CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-4030
Country	:	US
Telephone Number	:	713-213-8483
Fax Number	:

Provider Business Practice Location Address
First Line	:	7811 SPRINGBERRY CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-4030
Country	:	US
Telephone Number	:	713-213-8483
Fax Number	:

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

Provider Enumeration Date	:	05/11/2023
Last Update Date	:	05/11/2023

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