Provider Demographics
NPI:1013913920
Name:WRIGHT, DAVID R (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9596 WILLIAM PENN HWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-7165
Mailing Address - Country:US
Mailing Address - Phone:814-506-8323
Mailing Address - Fax:814-506-8329
Practice Address - Street 1:9596 WILLIAM PENN HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-7165
Practice Address - Country:US
Practice Address - Phone:814-506-8323
Practice Address - Fax:814-506-8329
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA802728OtherMEDICARE PTAN
PA2545820OtherHIGHMARK BCBS