Individual
CAREY L BERNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1550
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120239100
—
WY
01
—
S110218
MEDICARE PTAN
SD
Enumeration date
04/17/2006
Last updated
06/03/2016
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