Provider Demographics
NPI:1750577003
Name:BERGHER, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:BERGHER
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 1:205 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5629
Mailing Address - Country:US
Mailing Address - Phone:928-204-1347
Mailing Address - Fax:
Practice Address - Street 1:205 WILLOW WAY
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5629
Practice Address - Country:US
Practice Address - Phone:928-204-1347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ68786Medicare PIN