Individual
SUSAN LEE BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 E 3RD ST, DULUTH, MN 55805-1950
(218) 786-4004
Mailing address
407 E 3RD ST, DULUTH, MN 55805-1950
(218) 786-4004
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100516
MN
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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