Provider Demographics
NPI:1770861619
Name:WRIGHT, JOSHUA COLE WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:COLE WILLIAM
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:TONTITOWN
Mailing Address - State:AR
Mailing Address - Zip Code:72770-0871
Mailing Address - Country:US
Mailing Address - Phone:479-751-3900
Mailing Address - Fax:
Practice Address - Street 1:1112 S 48TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-5848
Practice Address - Country:US
Practice Address - Phone:479-751-3900
Practice Address - Fax:479-751-3011
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist