Provider Demographics
NPI:1538393095
Name:WRIGHT, ANTHONY JAMAL (LAT,ATC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JAMAL
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LAT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CLOVER RD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-1681
Mailing Address - Country:US
Mailing Address - Phone:781-223-7866
Mailing Address - Fax:
Practice Address - Street 1:47 CLOVER RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-1681
Practice Address - Country:US
Practice Address - Phone:781-961-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer