Provider Demographics
NPI:1043314487
Name:DAVIS, SANDRA LYNN WRIGHT (PT, MPT, PCS)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNN WRIGHT
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT, MPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2318
Mailing Address - Street 2:
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723-2318
Mailing Address - Country:US
Mailing Address - Phone:910-868-6000
Mailing Address - Fax:
Practice Address - Street 1:7532 WILKINS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9338
Practice Address - Country:US
Practice Address - Phone:910-868-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0001311041C0700X
225100000X
NCP74522251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7210537Medicaid