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Individual

MRS. JAN BERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L, RYT-200

Contact information

Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-7313
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-7313

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
021186
NY
225X00000X
Occupational Therapist
Primary
368456
OR

Other

Enumeration date
02/15/2017
Last updated
12/19/2023
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