Individual
DR. BONNIE L BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
314 MAIN ST, MEDFORD, MA 02155-6160
(781) 396-1070
(781) 396-6607
Mailing address
314 MAIN ST, MEDFORD, MA 02155-6160
(781) 396-1070
(781) 396-6607
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1118
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
351243
HARVARD/PILGRAM NUMBER
MA
01
—
4130676
AETNA NUMBER
MA
01
—
713630
TUFTS NUMBER
MA
Enumeration date
08/17/2006
Last updated
07/09/2007
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