Healthcare Provider Details

I. General information

NPI: 1902389414
Provider Name (Legal Business Name): NATHAN WRIGHT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 W FRANKLIN ST
EVANSVILLE IN
47712-5118
US

IV. Provider business mailing address

2305 W FRANKLIN ST
EVANSVILLE IN
47712-5118
US

V. Phone/Fax

Practice location:
  • Phone: 812-306-7590
  • Fax:
Mailing address:
  • Phone: 812-306-7590
  • Fax: 812-295-4489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08003053A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: