KATHARINE BERGART
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1023465390- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1415 S HWY 89, JACKSON, WY, 830018515
- Phone
- (307) 739-8999
- Fax
- (307) 739-4811
Specialties & Taxonomies
Physician Assistant
License: WA #PA60805916
Physician Assistant
Primary License: WY #PA991