MEDICARE: DR. HOWARD DARYL FERN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5306	AZ

General Provider Information

NPI Number	:	1417950999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD DARYL FERN D.C.

Provider Business Mailing Address
First Line	:	201 W GUADALUPE RD STE 311
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3319
Country	:	US
Telephone Number	:	480-649-5868
Fax Number	:	480-649-5870

Provider Business Practice Location Address
First Line	:	201 W GUADALUPE RD STE 311
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3319
Country	:	US
Telephone Number	:	480-649-5868
Fax Number	:	480-649-5870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/19/2023

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