Individual
ROBERT WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 W SR 164, SALEM, UT 84653-8465
(801) 465-4896
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12480125-1206
UT
363AM0700X
Medical Physician Assistant
12480125-1206
UT
Other
Enumeration date
09/25/2021
Last updated
12/29/2022
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