Provider Demographics
NPI:1801845102
Name:WRIGHT, JAMES GREGORY (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GREGORY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 WIMBLEDOM DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANDREAS
Mailing Address - State:CA
Mailing Address - Zip Code:95249-9736
Mailing Address - Country:US
Mailing Address - Phone:209-754-9471
Mailing Address - Fax:
Practice Address - Street 1:813 COURT ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2131
Practice Address - Country:US
Practice Address - Phone:209-223-3250
Practice Address - Fax:209-223-2517
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 27978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist