Individual
CALVIN RAY BERGHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2800 S DIXON RD, KOKOMO, IN 46902-6403
(866) 738-6128
Mailing address
7473 W 200 N, KOKOMO, IN 46901-9663
(765) 480-3476
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005078A
IN
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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