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Individual

MR. FREDRICK R BERGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
120 S PALM AVE, PALATKA, FL 32177-4140
(386) 325-3500
Mailing address
251 FEDERAL POINT RD, EAST PALATKA, FL 32131-4329
(386) 328-2225

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
46239
FL

Other

Enumeration date
11/06/2006
Last updated
07/08/2007
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