Individual
JEREMY BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
708A WINDOVER RD, JONESBORO, AR 72401-6064
(870) 219-0829
(870) 932-1155
Mailing address
PO BOX 596, BONO, AR 72416-0596
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2344
AR
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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