Provider Demographics
NPI:1538685268
Name:WRIGHT, JAMES KELLY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KELLY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 WALTON DRIVE
Mailing Address - Street 2:UNIT C4
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-7427
Mailing Address - Country:US
Mailing Address - Phone:843-790-5151
Mailing Address - Fax:
Practice Address - Street 1:3620 WALTON DR UNIT C4
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-6782
Practice Address - Country:US
Practice Address - Phone:843-790-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor