Provider Demographics
NPI:1922218072
Name:WRIGHT, JENNIFER LYNN (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-1218
Mailing Address - Country:US
Mailing Address - Phone:931-446-3523
Mailing Address - Fax:
Practice Address - Street 1:815 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TN
Practice Address - Zip Code:38474-1017
Practice Address - Country:US
Practice Address - Phone:931-379-3510
Practice Address - Fax:931-379-3491
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003650225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant