Provider Demographics
NPI:1407015696
Name:GARY B. WRIGHT CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:GARY B. WRIGHT CHIROPRACTIC CORPORATION
Other - Org Name:SPORTS & FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-956-2225
Mailing Address - Street 1:1842 W LINCOLN AVE STE F
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5489
Mailing Address - Country:US
Mailing Address - Phone:714-956-2225
Mailing Address - Fax:714-956-5350
Practice Address - Street 1:1842 W LINCOLN AVE STE F
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5489
Practice Address - Country:US
Practice Address - Phone:714-956-2225
Practice Address - Fax:714-956-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center