Provider Demographics
NPI:1205898657
Name:WRIGHT, WILFRED JOSEPH JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:JOSEPH
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:909 N MIAMI BEACH BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3712
Mailing Address - Country:US
Mailing Address - Phone:305-940-3506
Mailing Address - Fax:305-944-8055
Practice Address - Street 1:909 N MIAMI BEACH BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3712
Practice Address - Country:US
Practice Address - Phone:305-940-3506
Practice Address - Fax:305-944-8055
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87982OtherBCBS
FL87982AMedicare ID - Type Unspecified
FL87982OtherBCBS