Berg, Kevin

Berg, Kevin is an individual health care provider with primary practice located at 1210 Woodbury Cmn Unit D, Waukesha WI 53189-7780. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Berg, Kevin can be contacted via phone (262) 542-8949.

Contact Information

Primary practice address
1210 Woodbury Cmn Unit D Waukesha WI 53189-7780
Phone: (262) 542-8949
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 285-19 Wisconsin

Profile Details

NPI number 1922308964
LBN Legal business name Berg, Kevin
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2010
Last updated Aug 21st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922308964 NPPES
Wisconsin MEDICAID 100013086

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