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General NPI Number Information
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NPI Number | 1902922883
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Entity Type | Individual
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Provider Name | BRADLEY SCOTT WRIGHT ATC
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5633 SATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652
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Country | US
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Telephone | 727-372-0091
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Fax |
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Provider Business Mailing Address
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Address Line | 9234 BINNACLE DR #922
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City | PORT RICHEY
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State | FL
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Zip | 34668-4709
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Country | US
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Telephone | 727-742-8998
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL 1096
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License Number State | FL
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