Provider Demographics
NPI:1477958205
Name:WRIGHT, KJERSTIN (DPT)
Entity Type:Individual
Prefix:
First Name:KJERSTIN
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KJERSTIN
Other - Middle Name:
Other - Last Name:SCHILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 GREER AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4306
Mailing Address - Country:US
Mailing Address - Phone:701-872-6307
Mailing Address - Fax:
Practice Address - Street 1:15051 HARMONY HILLS LN
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7661
Practice Address - Country:US
Practice Address - Phone:276-451-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT4386225100000X
NH3939225100000X
VA2305213386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist