Individual
KIM BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
320 N 7TH ST, CORNELL, WI 54732-8120
(715) 239-0440
(715) 239-6608
Mailing address
E8625 595TH AVE, ELK MOUND, WI 54739-9037
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1724-019
WI
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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