Provider Demographics
NPI:1013455179
Name:WRIGHT, TONI (RADT1)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RADT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14037 CHADRON AVE
Mailing Address - Street 2:#42
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8234
Mailing Address - Country:US
Mailing Address - Phone:323-602-4872
Mailing Address - Fax:
Practice Address - Street 1:11905 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-2897
Practice Address - Country:US
Practice Address - Phone:323-312-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No172V00000XOther Service ProvidersCommunity Health Worker