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General NPI Number Information
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NPI Number | 1396924551
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Entity Type | Organization
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Legal Business Name | WRIGHT CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 633 E RAY RD STE 110
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City | GILBERT
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State | AZ
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Zip | 85296-4202
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Country | US
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Telephone | 480-222-6059
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Fax | 480-664-2093
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Provider Business Mailing Address
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Address Line | 633 E RAY RD STE 110
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City | GILBERT
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State | AZ
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Zip | 85296-4202
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Country | US
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Telephone | 480-222-6059
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Fax | 480-664-2093
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN R WRIGHT
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Credential | DC
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Telephone | 480-222-6059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 4012
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 7327
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License Number State | AZ
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