JACK ALTON BERGH

LUTZ, FL
NPI1376506394
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME0056971)
Enumeration Date2006-04-10
Last Update Date2013-01-08
Business Address
-- JACK ALTON BERGH MD
1539 DALE MABRY HWY STE 102
LUTZ, FL 33548
Phone number: 813-909-7102
Mailing Address
-- JACK ALTON BERGH MD
14743 MORNING DR
LUTZ, FL 33559-3257
Phone number: 813-975-4743