Provider Demographics
NPI:1144246315
Name:SPINEWRIGHT, INC.
Entity Type:Organization
Organization Name:SPINEWRIGHT, INC.
Other - Org Name:WRIGHT CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT - CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-622-1546
Mailing Address - Street 1:820 SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1718
Mailing Address - Country:US
Mailing Address - Phone:757-622-1546
Mailing Address - Fax:757-623-3005
Practice Address - Street 1:820 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1718
Practice Address - Country:US
Practice Address - Phone:757-622-1546
Practice Address - Fax:757-623-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA350046127Medicare PIN
VAC02493Medicare PIN
VAT21480Medicare UPIN
VA350888014Medicare PIN