Individual
KELLY DORSANNE BERGHEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7373 147TH ST W, SUITE 108, APPLE VALLEY, MN 55124-7690
(651) 442-3622
Mailing address
5013 147TH ST W, APPLE VALLEY, MN 55124-6918
(651) 442-3622
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/20/2010
Last updated
07/21/2014
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