Individual
JONATHAN MICHAEL DANIEL BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2108 E BOULEVARD, KOKOMO, IN 46902-2401
(765) 626-0200
(765) 626-0201
Mailing address
2108 E BOULEVARD, KOKOMO, IN 46902-2401
(765) 626-0200
(765) 626-0201
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002169A
IN
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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