Provider Demographics
NPI:1164832846
Name:BRIGHT, JOHN (ATC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 TRANQUIL DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-8956
Mailing Address - Country:US
Mailing Address - Phone:480-266-8155
Mailing Address - Fax:937-376-6291
Practice Address - Street 1:1400 BRUSH ROW RD
Practice Address - Street 2:
Practice Address - City:WILBERFORCE
Practice Address - State:OH
Practice Address - Zip Code:45384-5800
Practice Address - Country:US
Practice Address - Phone:937-376-6130
Practice Address - Fax:937-376-6291
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0033962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer