MEDICARE: DR. FREDERICK ROGER WRIGHT D.C.

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	111N00000X	Chiropractor	2301002832	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417916511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK ROGER WRIGHT D.C.

Provider Business Mailing Address
First Line	:	23843 JOY RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1480
Country	:	US
Telephone Number	:	313-561-6848
Fax Number	:	313-561-2252

Provider Business Practice Location Address
First Line	:	23843 JOY RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1480
Country	:	US
Telephone Number	:	313-561-6848
Fax Number	:	313-561-2252

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	07/12/2010

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