Provider Demographics
NPI:1700847829
Name:BRIGHT, STEPHEN L JR (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:L
Last Name:BRIGHT
Suffix:JR
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5223 LONE EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-3993
Mailing Address - Country:US
Mailing Address - Phone:910-612-2214
Mailing Address - Fax:
Practice Address - Street 1:1717 SHIPYARD BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8019
Practice Address - Country:US
Practice Address - Phone:910-791-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist