Individual
AMY MARIE BERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4202 E FOWLER AVE STOP ATH100, TAMPA, FL 33620-8455
(406) 438-6395
Mailing address
4202 E FOWLER AVE STOP ATH100, TAMPA, FL 33620-8455
(406) 438-6395
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3942
FL
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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