MEDICARE: LEAH WRIGHT

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
1	2255A2300X	Athletic Trainer	W09-883-205	KY

General Provider Information

NPI Number	:	1548192024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH WRIGHT

Provider Business Mailing Address
First Line	:	335 POPES CREEK RD
Second Line	:
City	:	LEBANON
State	:	KY
Zip	:	40033-9747
Country	:	US
Telephone Number	:	270-699-5988
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 POPES CREEK RD
Second Line	:
City	:	LEBANON
State	:	KY
Zip	:	40033-9747
Country	:	US
Telephone Number	:	270-699-5988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ LEAH WRIGHT ” Practice Location

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