Provider Demographics
NPI:1548420987
Name:WRIGHT, TANYA VICTORIA (LPTA)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:VICTORIA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 MAINSAIL LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-3218
Mailing Address - Country:US
Mailing Address - Phone:910-200-7317
Mailing Address - Fax:
Practice Address - Street 1:3015 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-2116
Practice Address - Country:US
Practice Address - Phone:910-791-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1307225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant