Individual
ASHLEY BERGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1961 S BROADWAY AVE, BOISE, ID 83706-4201
(208) 422-9826
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7523
ID
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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