Individual
ALYCEAN MARYRAE BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10950 CLUB WEST PKWY STE 190, BLAINE, MN 55449-4679
(763) 400-4940
Mailing address
10950 CLUB WEST PKWY STE 190, BLAINE, MN 55449-4679
(763) 400-4940
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6018
MN
171100000X
Acupuncturist
1076
MN
Other
Enumeration date
01/05/2015
Last updated
01/12/2024
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