Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CHIR009831 | GA |
Y | 111NP0017X | Pediatric Chiropractor | CHIR009831 | GA |
NPI | 1730609470 |
---|---|
Provider Name | Danielle Wright |
First Address | Hoschton, GA 30548-1996 |
Second Address | Hoschton, GA 30548-1996 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2017 |
Last Update Date | 14/02/2019 |