Individual
JETAUN WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 392-6001
Mailing address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 392-6001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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