Provider Demographics
NPI:1124524111
Name:GARST, BRYCE (DC)
Entity type:Individual
Prefix:DR
First Name:BRYCE
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 1:2451 E BASELINE RD STE 450
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2473
Mailing Address - Country:US
Mailing Address - Phone:480-656-1233
Mailing Address - Fax:
Practice Address - Street 1:6836 E BROWN RD STE 102
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3756
Practice Address - Country:US
Practice Address - Phone:480-582-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor