Individual
MR. JONATHAN BERRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT ATC OTC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RT006128
PA
246ZX2200X
Orthopedic Assistant
Primary
17-0629
PA
Other
Enumeration date
09/24/2015
Last updated
08/24/2018
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