Individual
DR. MARK JEROME BERGTHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2707 KIMBERLY RD, BETTENDORF, IA 52722
(563) 359-0073
(563) 359-0073
Mailing address
2707 KIMBERLY RD, BETTENDORF, IA 52722
(563) 359-0073
(563) 359-0073
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05483
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007146
—
IA
Enumeration date
02/15/2007
Last updated
02/25/2008
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