Provider Demographics
NPI:1184074106
Name:WRIGHT, ROBERT JOHN (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 BUCK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-3702
Mailing Address - Country:US
Mailing Address - Phone:215-499-6424
Mailing Address - Fax:
Practice Address - Street 1:1325 SUMNEYTOWN PIKE
Practice Address - Street 2:
Practice Address - City:GWYNEDD VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19437
Practice Address - Country:US
Practice Address - Phone:215-646-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0056592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer