Provider Demographics
NPI:1659606309
Name:WRIGLEY, JAY ALAN (ND)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:ALAN
Last Name:WRIGLEY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5707
Mailing Address - Country:US
Mailing Address - Phone:704-332-1201
Mailing Address - Fax:704-332-7201
Practice Address - Street 1:1201 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5707
Practice Address - Country:US
Practice Address - Phone:704-332-1201
Practice Address - Fax:704-332-7201
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3512175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath