Individual
DAVID BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1160 SW SIMPSON AVE STE 200, BEND, OR 97702-3542
(541) 322-9045
Mailing address
5107 LONDON RD, DULUTH, MN 55804-2414
(218) 370-1499
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63743
OR
2251X0800X
Orthopedic Physical Therapist
63743
OR
Other
Enumeration date
07/27/2020
Last updated
08/11/2020
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