Individual
CHAD M BERGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1329
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030477097
WORK FORCE SAFETY
ND
05
—
1475369
—
ND
05
—
54130
—
ND
01
—
650024893
PALMETTO GBA
ND
Enumeration date
03/30/2006
Last updated
12/27/2021
Update your record
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