Organization
FAMILY ALLERGY CENTER,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ROBERT BERGMAN M.D. (PRESIDENT)
(703) 263-2333
Entity
Organization
Contact information
Practice address
13890 BRADDOCK RD, SUITE 206, CENTREVILLE, VA 20121-2435
(703) 263-2333
(703) 263-0361
Mailing address
13890 BRADDOCK RD, SUITE 206, CENTREVILLE, VA 20121-2435
(703) 263-2333
(703) 263-0361
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
0101025702
VA
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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