Provider Demographics
NPI:1033270681
Name:BERGMANN, KARL (PT)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:BERGMANN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5043 RAVENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6783
Mailing Address - Country:US
Mailing Address - Phone:757-268-6954
Mailing Address - Fax:
Practice Address - Street 1:5043 RAVENWOOD RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6783
Practice Address - Country:US
Practice Address - Phone:757-268-6954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0244102251X0800X
PAPT0265012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic