Provider Demographics
NPI:1790710671
Name:WRIGHT, HERBERT D (DPM DC)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DPM DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14122 W MCDOWELL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2503
Mailing Address - Country:US
Mailing Address - Phone:623-547-4574
Mailing Address - Fax:623-547-0253
Practice Address - Street 1:14122 W MCDOWELL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2503
Practice Address - Country:US
Practice Address - Phone:623-547-4574
Practice Address - Fax:623-547-0253
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor