Individual
JEFFREY WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 ANDROMEDA CT, GREENVILLE, SC 29615-5433
(954) 248-0737
Mailing address
4 ANDROMEDA CT, GREENVILLE, SC 29615-5433
(954) 248-0737
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
200631
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006301
—
SC
Enumeration date
08/22/2019
Last updated
08/22/2019
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