MEDICARE: DR. JUSTIN R. WRIGHT, D.C., P.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

General Provider Information

NPI Number	:	1700075504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JUSTIN R. WRIGHT, D.C., P.C.

Provider Business Mailing Address
First Line	:	201 E OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2327
Country	:	US
Telephone Number	:	602-798-6867
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JUSTIN RONALD WRIGHT
Credential	:	D.C.
Telephone Number	:	602-796-6867

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	01/24/2008

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