Provider Demographics
NPI:1033459821
Name:WRIGHT, SCOTT MONROE (PTA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MONROE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 GARDNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:TAMWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03886-5008
Mailing Address - Country:US
Mailing Address - Phone:603-662-5851
Mailing Address - Fax:
Practice Address - Street 1:593 GARDNER HILL ROAD
Practice Address - Street 2:
Practice Address - City:TAMWORTH
Practice Address - State:NH
Practice Address - Zip Code:03886
Practice Address - Country:US
Practice Address - Phone:603-662-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0474225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant