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General NPI Number Information
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NPI Number | 1407271901
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Entity Type | Individual
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Provider Name | CORY WRIGHT
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Gender | Male
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 6160 TUTT BLVD STE 240
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923
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Country | US
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Telephone | 719-596-0880
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Fax | 195-960-8997
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Provider Business Mailing Address
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Address Line | 6160 TUTT BLVD STE 240
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3502
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Country | US
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Telephone | 719-596-0880
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Fax | 719-265-6649
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0015102
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License Number State | CO
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