Provider Demographics
NPI:1073733945
Name:WRIGHT, JEAN CRAIGIN
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:CRAIGIN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:CHRISTINE
Other - Last Name:CRAIGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-0474
Mailing Address - Country:US
Mailing Address - Phone:802-434-3146
Mailing Address - Fax:
Practice Address - Street 1:1110 PRIM RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-6403
Practice Address - Country:US
Practice Address - Phone:802-658-1900
Practice Address - Fax:802-860-4454
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0002066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist