MEDICARE: FREDERICK R. 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	2301002832	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962561472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREDERICK R. WRIGHT, D.C.

Provider Business Mailing Address
First Line	:	23843 JOY RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1480
Country	:	US
Telephone Number	:	313-561-6848
Fax Number	:	313-561-2252

Provider Business Practice Location Address
First Line	:	23843 JOY RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1480
Country	:	US
Telephone Number	:	313-561-6848
Fax Number	:	313-561-2252

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FREDERICK ROGER WRIGHT
Credential	:	D.C.
Telephone Number	:	313-561-6848

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	08/22/2020

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