Provider Demographics
NPI:1275737512
Name:WRIGHT, JEFFREY W (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:W
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11013 JOHN PAUL JONES AVE
Mailing Address - Street 2:
Mailing Address - City:FT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4162
Mailing Address - Country:US
Mailing Address - Phone:301-292-2463
Mailing Address - Fax:
Practice Address - Street 1:11013 JOHN PAUL JONES AVE
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4162
Practice Address - Country:US
Practice Address - Phone:301-292-1758
Practice Address - Fax:301-292-1759
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist