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1760110415
SHANE RUSSELL WRIGHT
GRAND JUNCTION, CO
NPI
1760110415
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2022-08-10
Last Update Date
2022-08-31
Business Address
SHANE RUSSELL WRIGHT PA
2373 G RD STE 100
GRAND JUNCTION, CO 81505-1003
Phone number: 970-245-0484
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Mailing Address
SHANE RUSSELL WRIGHT PA
PO BOX 1727
GRAND JUNCTION, CO 81502-1727
Phone number: 970-245-0484
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