Healthcare Provider Details

I. General information

NPI: 1871768044
Provider Name (Legal Business Name): WRIGHT CHIROPRACTIC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N BEECH ST STE A
NORMAL IL
61761-2108
US

IV. Provider business mailing address

406 N BEECH ST STE A
NORMAL IL
61761-2108
US

V. Phone/Fax

Practice location:
  • Phone: 309-454-1800
  • Fax:
Mailing address:
  • Phone: 309-454-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number038005831
License Number StateIL

VIII. Authorized Official

Name: DR. DONALD LEE WRIGHT
Title or Position: OWNER/SOLE PROPRIETOR
Credential: D.C.
Phone: 309-454-1800