Provider Demographics
NPI:1821039082
Name:BERNARD, DONALD J (DC, FIACA)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:BERNARD
Suffix:
Gender:M
Credentials:DC, FIACA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1840 E BASELINE RD
Mailing Address - Street 2:STE. A-1
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1527
Mailing Address - Country:US
Mailing Address - Phone:480-833-4515
Mailing Address - Fax:480-833-5078
Practice Address - Street 1:2730 S VAL VIST DR
Practice Address - Street 2:BLDG 15
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296
Practice Address - Country:US
Practice Address - Phone:480-324-0244
Practice Address - Fax:480-324-0589
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ5458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor