Provider Demographics
NPI:1760883268
Name:WRIGHT, TARA (DC)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 N RONALD REAGAN BLVD STE 1015
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4159
Mailing Address - Country:US
Mailing Address - Phone:407-790-7990
Mailing Address - Fax:607-377-5312
Practice Address - Street 1:351 N RONALD REAGAN BLVD STE 1015
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4159
Practice Address - Country:US
Practice Address - Phone:407-790-7990
Practice Address - Fax:607-377-5312
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012696111N00000X
FLCH11282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor