Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8933 | TX |
NPI | 1003985193 |
---|---|
Provider Name | Heather M Wright |
First Address | Weatherford, TX 76086-6519 |
Second Address | Weatherford, TX 76086-6519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8P5470 | BCBS (01) | TX |
U84903 | (02) |