Provider Demographics
NPI:1790951804
Name:WRIGHT, ELIZABETH MARY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARY
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:MCFETRIDGE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3514 WINCHESTER ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-893-9890
Mailing Address - Fax:502-893-9890
Practice Address - Street 1:1155 OLD EKRON RD
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108
Practice Address - Country:US
Practice Address - Phone:502-836-5093
Practice Address - Fax:502-893-9890
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist