Provider Demographics
NPI:1407361355
Name:WRIGHT, LAURA PETERSON (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:PETERSON
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 7916
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-7916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1325 S HWY 89 APT 108
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8293
Practice Address - Country:US
Practice Address - Phone:307-699-3447
Practice Address - Fax:307-939-2266
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor