Individual
JESSICA LEIGH BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
605 W STATE ST, MEDIA, PA 19063-2620
(610) 565-8600
(610) 891-9238
Mailing address
605 W STATE ST, MEDIA, PA 19063-2620
(610) 565-8600
(610) 891-9238
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA058785
PA
Other
Enumeration date
01/03/2017
Last updated
09/30/2019
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