Provider Demographics
NPI:1962693986
Name:WRIGHT, JUSTIN RONALD (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:RONALD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:4432 N MILLER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3697
Mailing Address - Country:US
Mailing Address - Phone:480-945-0008
Mailing Address - Fax:480-945-2778
Practice Address - Street 1:9971 W CAMELBACK RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5011
Practice Address - Country:US
Practice Address - Phone:623-872-0002
Practice Address - Fax:623-872-1112
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2013-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ7361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ92454Medicare PIN
AZZ154048Medicare PIN