Individual
BRENDAN J BERTHOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDMS
Contact information
Practice address
14791 E 54TH DR, YUMA, AZ 85367-9210
(928) 276-5658
Mailing address
14791 E 54TH DR, YUMA, AZ 85367-9210
(928) 276-5658
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
155899
AZ
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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