Individual
AMY BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 SUMMIT DR, POINT PLEASANT BORO, NJ 08742-2781
(732) 674-6939
Mailing address
540 SUMMIT DR, POINT PLEASANT BORO, NJ 08742-2781
(732) 674-6939
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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