Individual
GERALD C BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
18275 N 59TH AVE, BLDG A SUITE 106, GLENDALE, AZ 85308-1260
(602) 375-2225
(602) 942-5662
Mailing address
18275 N 59TH AVE, BLDG A SUITE 106, GLENDALE, AZ 85308-1260
(602) 375-2225
(602) 942-5662
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7831 AND 4520 PHYSIO
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477686541
MEDICARE NPI GROUP
AZ
01
—
1962576512
BLUE CROSS BLUE SHIELD
AZ
01
—
Z100607
MEDICARE GROUP
AZ
Enumeration date
11/17/2006
Last updated
01/02/2008
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