Provider Demographics
NPI:1992720890
Name:WRIGHT, CLIFF S (DC)
Entity type:Individual
Prefix:DR
First Name:CLIFF
Middle Name:S
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 1:49 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-1212
Mailing Address - Country:US
Mailing Address - Phone:765-489-5870
Mailing Address - Fax:765-489-4151
Practice Address - Street 1:49 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1212
Practice Address - Country:US
Practice Address - Phone:765-489-5870
Practice Address - Fax:765-489-4151
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000386016OtherANTHEM BLUE CROSS BLUE SH
IN11533665OtherCAQH
IN11533665OtherCAQH
INU88575Medicare UPIN