Provider Demographics
NPI:1528030350
Name:WRIGHT, WARREN (OT)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 E HARMONY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8620
Mailing Address - Country:US
Mailing Address - Phone:970-313-2775
Mailing Address - Fax:970-313-2727
Practice Address - Street 1:1008 W 35TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806
Practice Address - Country:US
Practice Address - Phone:563-324-2263
Practice Address - Fax:563-324-0719
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00844225X00000X
IL056.006951225X00000X
CO996174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist