Individual
COURTNEY LYNN BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 PROGRESS PKWY, STE GENEVIEVE, MO 63670-9232
(573) 883-3454
Mailing address
715 PCR 202, PERRYVILLE, MO 63775-9454
(573) 517-3906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2021010859
MO
Other
Enumeration date
01/15/2022
Last updated
01/15/2022
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