Provider Demographics
NPI:1184478166
Name:WRIGHT, DAMIAN MICHAEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:MICHAEL
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2037
Mailing Address - Country:US
Mailing Address - Phone:585-645-3956
Mailing Address - Fax:
Practice Address - Street 1:85 METRO PARK
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2607
Practice Address - Country:US
Practice Address - Phone:800-270-4904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134726PROV225100000X
NY051657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist