Provider Demographics
NPI:1043253552
Name:WRIGHT, JASON A (LAC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:2940 DARLING RD
Mailing Address - Street 2:
Mailing Address - City:INTERLAKEN
Mailing Address - State:NY
Mailing Address - Zip Code:14847-9748
Mailing Address - Country:US
Mailing Address - Phone:315-568-3132
Mailing Address - Fax:315-368-3700
Practice Address - Street 1:2360 STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-9425
Practice Address - Country:US
Practice Address - Phone:315-568-3166
Practice Address - Fax:315-568-3700
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001384-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist