Provider Demographics
NPI:1790201564
Name:WRIGHT, KULDIP (OTR/L)
Entity Type:Individual
Prefix:
First Name:KULDIP
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10631 WILLOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4740
Mailing Address - Country:US
Mailing Address - Phone:937-305-5657
Mailing Address - Fax:937-350-5153
Practice Address - Street 1:1728 DAYTON XENIA RD
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-7119
Practice Address - Country:US
Practice Address - Phone:937-458-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT007276225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation