MEDICARE: LANCE BERGMANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	040.0135014	VT

General Provider Information

NPI Number	:	1245183490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANCE BERGMANS

Provider Business Mailing Address
First Line	:	2003 MIDDLEBROOK RD
Second Line	:
City	:	FERRISBURGH
State	:	VT
Zip	:	05456-9628
Country	:	US
Telephone Number	:	802-458-5636
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 EXCHANGE ST
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-1555
Country	:	US
Telephone Number	:	802-388-3991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ LANCE BERGMANS ” Practice Location

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