George Lynn Bardwell, D.C.
Individual provider Active NPI Nutrition Chiropractor · Williams, AZ
NPI 1295937589 · NPPES record last updated Jun 7, 2012
Key facts
- NPI
- 1295937589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutrition Chiropractor 111NN1001X
- License
- 898 (AZ)
- Practice address
- 706 N Grand Canyon Blvd.
Williams, AZ 86046-2200 - Phone
- (928) 635-9115
- Fax
- (928) 635-9115
- NPI assigned
- May 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 898 | AZ | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 898 | AZ | Yes |
Addresses
Primary practice location
706 N Grand Canyon Blvd.
Williams, AZ 86046-2200
Mailing address
706 N Grand Canyon Blvd
Williams, AZ 86046-2016
Phone (928) 635-9115
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 860363015 | Other | AZ | FED I D # |
Other providers in Williams, AZ
- Advanced Mental Health and Wellness PLLC
- Carrie Lynn Appleby
- Maria Arganoza-Priess
- Arizona Senior Care Centers
- Tyler Arkless
- Jill Ann Barrett
- Bellwether Ranch Foundation
- Jennifer Leigh Leigh Bowe
- Madison Braden
- CBT Health Services, LLC
All providers in Williams, AZ · Nutrition Chiropractor in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.