Individual
MR. CARL STACEY BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASTER OF SCIENCE MS
Contact information
Practice address
1867 WILLIAMS HWY, SUITE 105, GRANTS PASS, OR 97527-5854
(541) 474-4694
(541) 474-9590
Mailing address
1867 WILLIAMS HWY, SUITE 105, GRANTS PASS, OR 97527-5854
(541) 474-4694
(541) 474-9590
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
20545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283606
—
OR
Enumeration date
06/12/2006
Last updated
09/10/2014
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