Organization
DAKOTA PHYSICAL THERAPY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD M BERGAN (OWNER/PRESIDENT)
(701) 667-0745
Entity
Organization
Contact information
Practice address
606 1ST ST NW, MANDAN, ND 58554-3121
(701) 667-0745
(701) 667-0707
Mailing address
606 1ST ST NW, MANDAN, ND 58554-3121
(701) 667-0745
(701) 667-0707
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
ND
225X00000X
Occupational Therapist
—
ND
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460162
—
ND
01
—
5397930001
DMERC CIGNA
ND
05
—
54130
—
ND
01
—
5470001
BLUE SHIELD OF ND
ND
01
—
650024893
PALMETTO GBA
ND
Enumeration date
07/05/2006
Last updated
07/31/2024
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