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General NPI Number Information
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NPI Number | 1700075504
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Entity Type | Organization
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Legal Business Name | DR. JUSTIN R. WRIGHT, D.C., P.C.
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 201 E OSBORN RD
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City | PHOENIX
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State | AZ
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Zip | 85012-2327
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Country | US
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Telephone | 602-798-6867
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E OSBORN RD
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City | PHOENIX
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State | AZ
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Zip | 85012-2327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTIN RONALD WRIGHT
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Credential | D.C.
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Telephone | 602-796-6867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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