Provider Demographics
NPI:1588743967
Name:WRIGHT CHIROPRACTIC LLC
Entity type:Organization
Organization Name:WRIGHT CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:WILLIS
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-318-4774
Mailing Address - Street 1:6430 SKY POINTE DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4051
Mailing Address - Country:US
Mailing Address - Phone:702-318-4774
Mailing Address - Fax:702-318-4775
Practice Address - Street 1:6430 SKY POINTE DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4051
Practice Address - Country:US
Practice Address - Phone:702-318-4774
Practice Address - Fax:702-318-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC5981OtherBCBS
U91180Medicare UPIN
NVCC5981OtherBCBS