Provider Demographics
NPI:1205925351
Name:WRIGHT, TIMOTHY JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W ROCKRIMMON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1767
Mailing Address - Country:US
Mailing Address - Phone:719-593-1969
Mailing Address - Fax:719-593-0744
Practice Address - Street 1:425 W ROCKRIMMON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1767
Practice Address - Country:US
Practice Address - Phone:719-593-1969
Practice Address - Fax:719-593-0744
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO40765Medicare PIN