Individual
KEITH BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 HIGHWAY 169 N, ALGONA, IA 50511-1019
(515) 295-9238
(515) 295-9214
Mailing address
1500 HIGHWAY 169 N, ALGONA, IA 50511-1019
(515) 295-9238
(515) 295-9214
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18651
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18651
IOWA PHARMACIST LICENSE
IA
Enumeration date
02/25/2020
Last updated
02/25/2020
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