Individual
HEIDI KATHRYN BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3117 SHORE DR STE 101, MARINETTE, WI 54143-4293
(715) 732-5111
(715) 732-8220
Mailing address
1731 SUNNYSIDE LN, DE PERE, WI 54115-3465
(920) 676-9514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15011-24
WI
2251X0800X
Orthopedic Physical Therapist
15011-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100100866
—
WI
Enumeration date
06/30/2020
Last updated
01/10/2023
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