Healthcare Provider Details

I. General information

NPI: 1013985415
Provider Name (Legal Business Name): BRIAN WRIGHT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 E RAY RD STE 110
GILBERT AZ
85296-4202
US

IV. Provider business mailing address

633 E RAY RD STE 110
GILBERT AZ
85296-4202
US

V. Phone/Fax

Practice location:
  • Phone: 480-222-6059
  • Fax: 480-664-2093
Mailing address:
  • Phone: 480-222-6059
  • Fax: 480-664-2093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7327
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4012
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: