Most Relevant Information
Provider Data
| NPI Number: | 1003557760 |
| Provider Name: | ASHLEY JERMAINE WIGHT RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 5548 |
Most Important Dates
| Enumeration Date: | 04/06/2022 |
| Last Updated: | 04/06/2022 |
Provider Practice Location
55 LAKE AVE N
WORCESTER
MA
016550002
Practice Location Phone/Fax
| Phone: | 7744433411 |
| Fax: |
Provider Mailing Location
30 HERITAGE PATH
MILLIS
MA
020541750
Provider Mailing Phone/Fax
| Phone: | 7814419165 |
| Fax: |