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Individual

TRACY BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
250 G ST, BLAINE, WA 98230-4019
(360) 332-8167
Mailing address
4618 BEDFORD AVE, BELLINGHAM, WA 98226-1207

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160043890
WA

Other

Enumeration date
09/14/2010
Last updated
09/14/2010
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