| Doctor Name: | JASON THOMAS BERG |
| NPI Number: | 1922374818 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT |
| License Number: | PT 27059 |
| Business Practice Address: | 405 Racetrack Rd Ne Ste 101 Fort Walton Beach, FL - 325472561 |
| Business Phone Number: | 8508634747 |
| Business Fax Number: | 8508634658 |
| Mailing Address: | 405 Racetrack Rd Ne, Ste 101 FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325472561 |
| Phone Number: | 8508634747 |
| Fax Number: | 8508634658 |
| NPI Enumeration Date: | 03/26/2012 |
| NPI Last Update Date: | 05/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 27059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |