Individual
MR. GARY RANDALL WRIGHT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 N ALPINE RD, ROCKFORD, IL 61107-3673
(815) 395-9567
Mailing address
2122 BRADLEY RD, ROCKFORD, IL 61107-1260
(815) 399-6312
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
0887
IL
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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