Individual
HEATHER ANN BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
9951 W ST LUKES DR, NAMPA, ID 83687-7914
(208) 467-6700
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(888) 361-5391
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-279
ID
Other
Enumeration date
01/08/2010
Last updated
07/11/2022
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