Individual
HARLAN BERGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NBCHWC
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
Mailing address
405 S RUSK AVE APT 1, VIROQUA, WI 54665-2019
(815) 900-1580
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3273815
—
174H00000X
Health Educator
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
02/13/2007
Last updated
06/17/2024
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