Provider Demographics
NPI:1235599218
Name:BERGER, CAROLINE (AT, ATC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 VALHALLA DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9512
Mailing Address - Country:US
Mailing Address - Phone:419-345-2044
Mailing Address - Fax:
Practice Address - Street 1:7500 VALHALLA DR.
Practice Address - Street 2:
Practice Address - City:M'
Practice Address - State:OH
Practice Address - Zip Code:43537-9512
Practice Address - Country:US
Practice Address - Phone:419-345-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2000017844390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program