Provider Demographics
NPI:1730336660
Name:WRIGHT, CANDICE J
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:J
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:PRINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2510 PARKVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-1162
Mailing Address - Country:US
Mailing Address - Phone:505-980-0214
Mailing Address - Fax:
Practice Address - Street 1:7622 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4710
Practice Address - Country:US
Practice Address - Phone:719-495-3133
Practice Address - Fax:719-471-4415
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist