Individual
PATRICIA D. BERGLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1952
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1952
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-30
ID
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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