Provider Demographics
NPI:1548846801
Name:JULIEANN BERG, PT, DPT LLC
Entity type:Organization
Organization Name:JULIEANN BERG, PT, DPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIEANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:484-919-1066
Mailing Address - Street 1:1148 WHARTON ST APT 311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5072
Mailing Address - Country:US
Mailing Address - Phone:484-919-1066
Mailing Address - Fax:
Practice Address - Street 1:1148 WHARTON ST APT 311
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5072
Practice Address - Country:US
Practice Address - Phone:484-919-1066
Practice Address - Fax:484-496-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty