Provider Demographics
NPI:1922219088
Name:WRIGHT, ROBERT CLIVE (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CLIVE
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 1:1340 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7828
Mailing Address - Country:US
Mailing Address - Phone:561-352-0469
Mailing Address - Fax:561-733-5725
Practice Address - Street 1:1340 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7828
Practice Address - Country:US
Practice Address - Phone:561-352-0469
Practice Address - Fax:561-733-5725
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist