Individual
JUSTIN C WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3581
(920) 433-3706
(920) 433-3582
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4685-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1163406
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
01
—
4685-23
STATE OF WISCONSIN MEDICAL EXAMINING BOARD
WI
Enumeration date
05/21/2008
Last updated
12/18/2024
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