Provider Demographics
NPI:1992735153
Name:WRIGHT, DIANNE (PT)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:SCATTERGOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:124 ADDISON LN
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1687
Mailing Address - Country:US
Mailing Address - Phone:215-412-3042
Mailing Address - Fax:215-412-6778
Practice Address - Street 1:227 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-3816
Practice Address - Country:US
Practice Address - Phone:215-872-7822
Practice Address - Fax:215-412-6778
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT002333225100000X
PAPT010345L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA156662ZGBPMedicare UPIN