MEDICARE: MELCHOR V BORJA PT

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	2788	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184962037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELCHOR V BORJA PT

Provider Business Mailing Address
First Line	:	2870 S MARYLAND PKWY
Second Line	:	SUITE 230
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-5031
Country	:	US
Telephone Number	:	702-893-3333
Fax Number	:	702-893-0960

Provider Business Practice Location Address
First Line	:	4640 W CRAIG RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2743
Country	:	US
Telephone Number	:	702-839-0091
Fax Number	:	702-893-0095

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

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

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Directions to “ MELCHOR V BORJA PT” Practice Location

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