| NPI | 1982689584 |
|---|---|
| Other Name | STEPHANIE ANN BERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3836) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 4262) |
| 225100000X Physical Therapist (Licence: KS 11 02534) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2007-07-08 |