Individual
REBECCA BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 782-3131
Mailing address
3604 ARTISTS WAY, CHARLOTTE, NC 28205-1253
(919) 812-4307
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
267487
NC
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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