Individual
ANDREA C BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Mailing address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2624
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102420
—
AL
Enumeration date
05/15/2008
Last updated
04/27/2009
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