Individual
MATTHEW BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
1988 S 1100 E UNIT 506, SALT LAKE CITY, UT 84106-4723
(715) 587-5531
Mailing address
1988 S 1100 E UNIT 506, SALT LAKE CITY, UT 84106-4723
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9809678-4810
UT
Other
Enumeration date
12/01/2014
Last updated
12/13/2016
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