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NPI Code Detail

MEDICARE: VICTORIA WRIGHT MSPT

MEDICARE:   VICTORIA  WRIGHT  MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist30060CA

General Provider Information

NPI Number : 1124060207
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA WRIGHT MSPT
Provider Business Mailing Address
First Line : 3841 BRICKWAY BLVD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-8226
Country : US
Telephone Number : 707-569-2300
Fax Number : 707-569-2360
Provider Business Practice Location Address
First Line : 3841 BRICKWAY BLVD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-8226
Country : US
Telephone Number : 707-569-2300
Fax Number : 707-569-2360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 04/02/2013

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Directions to “ VICTORIA WRIGHT MSPT” Practice Location

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