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WRIGHT SURGICAL ASSISTANT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN ROGER WRIGHT (CERTIFIED SURGICAL ASSISTANT)
(757) 412-8017
Entity
Organization

Contact information

Practice address
4100 PERIDOT DR, VA BEACH, VA 23456-5804
(757) 412-8017
Mailing address
4100 PERIDOT DR, VIRGINIA BEACH, VA 23456-5804

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
1212
VA
282N00000X
General Acute Care Hospital
Primary
1212
VA

Other

Enumeration date
03/05/2015
Last updated
03/05/2015
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