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1427644756
THERESA LYNN BERGMAN
AVILLA, IN
NPI
1427644756
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32002091A)
Enumeration Date
2020-12-21
Last Update Date
2020-12-21
Business Address
THERESA LYNN BERGMAN Cota
515 N MAIN ST
AVILLA, IN 46710-9601
Phone number: 260-897-2841
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Mailing Address
THERESA LYNN BERGMAN Cota
PO BOX 182
AUBURN, IN 46706-0182
Phone number: 260-927-5102
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