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General NPI Number Information
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NPI Number | 1710951256
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Entity Type | Organization
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Legal Business Name | WRIGHTS PROSTHETIC LABORATORY INC
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 858 W PLYMOTH AVE
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City | DELAND
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State | FL
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Zip | 32720
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Country | US
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Telephone | 386-736-7314
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Fax | 386-736-7315
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Provider Business Mailing Address
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Address Line | 858 W PLYMOTH AVE
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City | DELAND
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State | FL
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Zip | 32720
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Country | US
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Telephone | 386-736-7314
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Fax | 386-736-7315
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM PATRICK WRIGHT
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Credential | CP
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Telephone | 386-736-7314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | PRO65
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License Number State | FL
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