Individual
MS. DALISA J WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLMT
Contact information
Practice address
116 PRAIRIEVIEW DR, CLOVIS, NM 88101-4234
(505) 763-5200
Mailing address
2508 N PRINCE ST, PMB 95, CLOVIS, NM 88101-4460
(505) 763-5200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
57752
NM
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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