Provider Demographics
NPI:1023052966
Name:WRIGHT, DONELL JEAN (DC)
Entity type:Individual
Prefix:
First Name:DONELL
Middle Name:JEAN
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 1:137 EAST MAIN STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642
Mailing Address - Country:US
Mailing Address - Phone:315-287-2400
Mailing Address - Fax:315-287-2903
Practice Address - Street 1:137 E. MAIN STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642
Practice Address - Country:US
Practice Address - Phone:315-287-2400
Practice Address - Fax:315-287-2903
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011217-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor