Individual
MRS. LISA MARIE WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
820 1ST STREET, LIMON, CO 80828-1120
(719) 775-2367
(719) 775-2365
Mailing address
414 PLYMOUTH NE, GRAND RAPIDS, MI 49505-6038
(616) 454-3465
(616) 242-7060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3018
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3018
MEDICAL LICENSE
CO
Enumeration date
10/26/2010
Last updated
07/10/2015
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