Provider Demographics
NPI:1629665609
Name:BERGER, SYDNEY (DC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 HOCHGESANG AVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3918
Mailing Address - Country:US
Mailing Address - Phone:812-634-9470
Mailing Address - Fax:
Practice Address - Street 1:4195 MANNHEIM RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9625
Practice Address - Country:US
Practice Address - Phone:812-634-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor