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1609832112
PHILIP A VANDE BERG
PHILADELPHIA, PA
NPI
1609832112
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: PA RT-003104)
Enumeration Date
2006-04-24
Last Update Date
2007-07-08
Business Address
Mr. PHILIP A VANDE BERG M.S., A.T.C.
3141 CHESTNUT ST
PHILADELPHIA, PA 19104-2816
Phone number: 215-895-0497
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Mailing Address
Mr. PHILIP A VANDE BERG M.S., A.T.C.
3141 CHESTNUT ST
PHILADELPHIA, PA 19104-2816
Phone number: 215-895-0497
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