Provider Demographics
NPI:1699814640
Name:WRIGHT, KIMBERLY (PT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-6833
Mailing Address - Country:US
Mailing Address - Phone:401-766-7246
Mailing Address - Fax:401-766-7248
Practice Address - Street 1:501 GREAT RD
Practice Address - Street 2:SUITE 108
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-6833
Practice Address - Country:US
Practice Address - Phone:401-766-7246
Practice Address - Fax:401-766-7248
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist