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General NPI Number Information
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NPI Number | 1720111263
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Entity Type | Individual
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Provider Name | CHRISTOPHER PETER BERCHEM PT
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 8811 92ND ST S SUITE 101
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-4036
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Country | US
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Telephone | 651-458-9446
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Fax | 651-458-0817
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Provider Business Mailing Address
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Address Line | 8811 92ND ST S STE 101
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-4037
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Country | US
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Telephone | 651-241-3777
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Fax | 651-241-3778
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 4286
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License Number State | MN
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