Provider Demographics
NPI:1063727519
Name:WRIGHT, MALENA S (PT)
Entity type:Individual
Prefix:
First Name:MALENA
Middle Name:S
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MALENA
Other - Middle Name:S
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1623 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6224
Mailing Address - Country:US
Mailing Address - Phone:307-382-3242
Mailing Address - Fax:307-382-3279
Practice Address - Street 1:416 W BLAIR AVE STE 2
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-7113
Practice Address - Country:US
Practice Address - Phone:307-382-3242
Practice Address - Fax:307-382-3279
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist