Individual
DALE BERGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1222 E WOODLAND AVE, BARRON, WI 54812-1765
(715) 537-3166
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
87
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730288150
—
WI
Enumeration date
09/22/2006
Last updated
08/16/2013
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