Provider Demographics
NPI:1932330776
Name:WRIGHT, LEWIS CALVIN III
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:CALVIN
Last Name:WRIGHT
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CHERRY AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4202
Mailing Address - Country:US
Mailing Address - Phone:360-478-2087
Mailing Address - Fax:360-405-6303
Practice Address - Street 1:2500 CHERRY AVE STE 102
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4202
Practice Address - Country:US
Practice Address - Phone:360-478-2087
Practice Address - Fax:360-405-6303
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07436651224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist