Provider Demographics
NPI:1831460054
Name:WRIGHT, ELYSSA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELYSSA
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ELYSSA
Other - Middle Name:MARIE
Other - Last Name:LINDENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3825 IRIS AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2005
Mailing Address - Country:US
Mailing Address - Phone:720-724-0998
Mailing Address - Fax:
Practice Address - Street 1:3825 IRIS AVE STE 300
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2070
Practice Address - Country:US
Practice Address - Phone:720-788-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA234960Medicare PIN