Provider Demographics
NPI:1053640979
Name:WRIGHT WELLNESS RESOURCES INC
Entity Type:Organization
Organization Name:WRIGHT WELLNESS RESOURCES INC
Other - Org Name:OPTIMUM FAMILY WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-936-9353
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-0386
Mailing Address - Country:US
Mailing Address - Phone:623-936-9353
Mailing Address - Fax:623-936-9354
Practice Address - Street 1:10320 W MCDOWELL RD
Practice Address - Street 2:SUITE E 5013
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4863
Practice Address - Country:US
Practice Address - Phone:623-936-9353
Practice Address - Fax:623-936-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7371305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1184653685Medicare PIN