Individual
MR. JASON NATHANIEL BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DAC
Contact information
Practice address
172 BROADWAY, PROVIDENCE, RI 02903-3014
(401) 523-3253
Mailing address
160 TRANSIT STREET, APT 3, PROVIDENCE, RI 02906
(401) 523-3253
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DA00312
RI
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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