Healthcare Provider Details

I. General information

NPI: 1962483941
Provider Name (Legal Business Name): WENDELL WRIGHT O.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CLINT HILL BLVD
PADUCAH KY
42001-6771
US

IV. Provider business mailing address

200 CLINT HILL BLVD
PADUCAH KY
42001-6768
US

V. Phone/Fax

Practice location:
  • Phone: 270-442-9461
  • Fax: 270-441-0079
Mailing address:
  • Phone: 270-442-9461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberR-1403
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number135492
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: