Provider Demographics
NPI:1578831673
Name:WRIGHT, LOREN D (DC)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:D
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 1:212 W IRONWOOD DR
Mailing Address - Street 2:#D116
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1403
Mailing Address - Country:US
Mailing Address - Phone:208-660-2730
Mailing Address - Fax:
Practice Address - Street 1:1210 N IDAHO ST
Practice Address - Street 2:BUILDING 3 SUITE C
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-8689
Practice Address - Country:US
Practice Address - Phone:208-777-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor