Individual
GREGORY BIDLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
18775 N REEMS RD, STE 360, SURPRISE, AZ 85374-8647
(623) 544-0200
Mailing address
17617 N 9TH ST, #1099, PHOENIX, AZ 85022-1935
(480) 217-9527
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3222
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0944530
BCBS
AZ
Enumeration date
01/08/2007
Last updated
09/29/2017
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