Provider Demographics
NPI:1619414539
Name:WRIGHT, BRITTANY N (DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1714 E WINDMILL WAY
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-2622
Mailing Address - Country:US
Mailing Address - Phone:417-233-4499
Mailing Address - Fax:417-374-0068
Practice Address - Street 1:813 S BUSINESS US HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-334-6660
Practice Address - Fax:417-334-6661
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2016039496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO480051053Medicaid