Provider Demographics
NPI:1437676384
Name:BERNER, RANDI LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:LYNN
Last Name:BERNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RANDI
Other - Middle Name:LYNN
Other - Last Name:GREENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7289 E LOWER WASH PASS
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1532
Mailing Address - Country:US
Mailing Address - Phone:480-406-3962
Mailing Address - Fax:
Practice Address - Street 1:7289 E LOWER WASH PASS
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1532
Practice Address - Country:US
Practice Address - Phone:480-406-3962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor