MEDICARE: DR. BRIAN WRIGHT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7327	AZ
2	111NR0400X	Rehabilitation Chiropractor	4012	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7327	OTHER	AZ	AZ BOARD NUMBER
2	4012	OTHER	AZ	PHYSIOTHERAPY CERTIFICATE

General Provider Information

NPI Number	:	1013985415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN WRIGHT D.C.

Provider Business Mailing Address
First Line	:	633 E RAY RD
Second Line	:	STE 110
City	:	GILBERT
State	:	AZ
Zip	:	85296-4202
Country	:	US
Telephone Number	:	480-222-6059
Fax Number	:	480-664-2093

Provider Business Practice Location Address
First Line	:	633 E RAY RD
Second Line	:	STE 110
City	:	GILBERT
State	:	AZ
Zip	:	85296-4202
Country	:	US
Telephone Number	:	480-222-6059
Fax Number	:	480-664-2093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	02/20/2008

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Directions to “ DR. BRIAN WRIGHT D.C.” Practice Location

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