Provider Demographics
NPI:1205456365
Name:WRIGHT, CAROLYN MICHELLE (DPT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2132
Mailing Address - Country:US
Mailing Address - Phone:423-581-8140
Mailing Address - Fax:
Practice Address - Street 1:1457 INDIAN CAVE RD
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:TN
Practice Address - Zip Code:37820-3543
Practice Address - Country:US
Practice Address - Phone:423-312-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-19
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist