| Doctor Name: | VICKI L BERGER |
| NPI Number: | 1306821079 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A. |
| License Number: | 215310-1206 |
| Business Practice Address: | 5991 S 3500 W Roy, UT - 84067 |
| Business Phone Number: | 8017738644 |
| Business Fax Number: | 8019850486 |
| Mailing Address: | 2086 N 1700 W, Suite C LAYTON |
| State: | UT |
| Postal Code: | 84041 |
| Phone Number: | 8017738644 |
| Fax Number: | 8019271591 |
| NPI Enumeration Date: | 12/14/2005 |
| NPI Last Update Date: | 09/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 215310-1206 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |