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General NPI Number Information
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NPI Number | 1588797922
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Entity Type | Organization
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Legal Business Name | DAKOTA PHYSICAL THERAPY, P C
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 1000 W CENTURY AVE
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City | BISMARCK
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State | ND
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Zip | 58503-0913
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Country | US
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Telephone | 701-355-1294
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Fax | 701-323-7046
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Provider Business Mailing Address
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Address Line | 606 1ST ST NW
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City | MANDAN
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State | ND
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Zip | 58554-3121
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Country | US
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Telephone | 701-667-0745
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Fax | 701-667-0707
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CHAD M BERGAN
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Credential |
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Telephone | 701-667-0745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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