Provider Demographics
NPI:1376768341
Name:BERG, VALERIE LOUISE (CERTIFIED ROLFER)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LOUISE
Last Name:BERG
Suffix:
Gender:F
Credentials:CERTIFIED ROLFER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3751 MANCHESTER DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-3090
Mailing Address - Country:US
Mailing Address - Phone:505-341-1167
Mailing Address - Fax:
Practice Address - Street 1:3751 MANCHESTER DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3090
Practice Address - Country:US
Practice Address - Phone:505-341-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner