Provider Demographics
NPI:1972924264
Name:GARST, ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:GARST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4852 E BASELINE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4628
Mailing Address - Country:US
Mailing Address - Phone:480-656-1233
Mailing Address - Fax:480-659-0197
Practice Address - Street 1:4852 E BASELINE RD STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4628
Practice Address - Country:US
Practice Address - Phone:480-656-1233
Practice Address - Fax:480-659-0197
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8399111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor