Provider Demographics
NPI:1942792338
Name:WRIGHT, TARYN MARIE
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SWAN VIEW LN
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-7706
Mailing Address - Country:US
Mailing Address - Phone:724-714-5099
Mailing Address - Fax:
Practice Address - Street 1:138 SWAN VIEW LN
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944-7706
Practice Address - Country:US
Practice Address - Phone:724-714-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211967225100000X
COPTL0015622225100000X
NCP18308225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist