Individual
KELSEY J BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 E 2ND ST, SUITE 201, CASPER, WY 82601-2946
(307) 577-8832
(307) 237-5421
Mailing address
167 S CONWELL ST STE 3, CASPER, WY 82601-2749
(307) 233-0246
(307) 237-5421
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR 765
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR 765
WYOMING STATE LICENSE NUMBER
WY
Enumeration date
05/13/2014
Last updated
05/14/2014
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