Individual
CHARLES LEE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 W STEVE OWENS BLVD, MIAMI, OK 74354-7629
(918) 542-2845
(918) 542-2848
Mailing address
130 W STEVE OWENS BLVD, MIAMI, OK 74354-7629
(918) 542-2845
(918) 542-2848
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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