Individual
NATHANIEL BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10501 QUEBEC AVE N, BROOKLYN PARK, MN 55445-1227
(612) 643-0911
Mailing address
10501 QUEBEC AVE N, BROOKLYN PARK, MN 55445-1227
(612) 643-0911
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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