Healthcare Provider Details

I. General information

NPI: 1073949715
Provider Name (Legal Business Name): CHE R BORGET ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHE R GOTHARD MED, ATC/LAT

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KINSMAN BARRACKS, BLDG 3305
APO AA
31905
US

IV. Provider business mailing address

3109 HATCHER DR
COLUMBUS GA
31907-2007
US

V. Phone/Fax

Practice location:
  • Phone: 828-676-4092
  • Fax:
Mailing address:
  • Phone: 828-676-4092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT004579
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: