Individual
DR. JENNIFER BERGVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5000 BAKERS MILL LN STE 170, RICHMOND, VA 23230-2432
(804) 359-0770
(804) 359-1106
Mailing address
5000 BAKERS MILL LN STE 170, RICHMOND, VA 23230-2432
(804) 359-0770
(804) 359-1106
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000957
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205894938
NPI
VA
Enumeration date
05/02/2006
Last updated
05/17/2022
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