Provider Demographics
NPI:1821268632
Name:BACKFIT GILBERT PLLC
Entity Type:Organization
Organization Name:BACKFIT GILBERT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-497-2900
Mailing Address - Street 1:754 S VAL VISTA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3139
Mailing Address - Country:US
Mailing Address - Phone:480-497-2900
Mailing Address - Fax:480-497-2906
Practice Address - Street 1:754 S VAL VISTA DR STE 105
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3139
Practice Address - Country:US
Practice Address - Phone:480-497-2900
Practice Address - Fax:480-497-2906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7708111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ110269Medicare UPIN