Organization
COUNTRYSIDE PHYSICAL THERAPY, PLLC
Active
Other names
Countryside Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TYLEA BERGMAN DPT (OWNER)
(605) 390-4326
Entity
Organization
Contact information
Practice address
42 CENTRAL AVE S, KILLDEER, ND 58640-4000
(605) 390-4326
Mailing address
PO BOX 993, KILLDEER, ND 58640-0993
(605) 390-4326
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
12/19/2019
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