Provider Demographics
NPI:1881904233
Name:BERGJORD, CAPRI (ATC, CES)
Entity type:Individual
Prefix:
First Name:CAPRI
Middle Name:
Last Name:BERGJORD
Suffix:
Gender:F
Credentials:ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2352 N 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8168
Mailing Address - Country:US
Mailing Address - Phone:970-241-5585
Mailing Address - Fax:
Practice Address - Street 1:2352 N 7TH ST STE A
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8168
Practice Address - Country:US
Practice Address - Phone:970-241-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant