Healthcare Provider Details

I. General information

NPI: 1376768341
Provider Name (Legal Business Name): VALERIE LOUISE BERG CERTIFIED ROLFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 MANCHESTER DR NW
ALBUQUERQUE NM
87107-3090
US

IV. Provider business mailing address

3751 MANCHESTER DR NW
ALBUQUERQUE NM
87107-3090
US

V. Phone/Fax

Practice location:
  • Phone: 505-341-1167
  • Fax:
Mailing address:
  • Phone: 505-341-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: