Provider Demographics
NPI:1396028577
Name:WRIGHT FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WRIGHT FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-972-6568
Mailing Address - Street 1:PO BOX 3799
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26103-3799
Mailing Address - Country:US
Mailing Address - Phone:304-972-6568
Mailing Address - Fax:304-861-5352
Practice Address - Street 1:2301 CAMDEN AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5610
Practice Address - Country:US
Practice Address - Phone:304-972-6568
Practice Address - Fax:304-861-5352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100064390Medicaid