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General NPI Number Information
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NPI Number | 1245558352
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Entity Type | Individual
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Provider Name | CHRISTOPHER CHARLES BORCK
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Gender | Male
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 2300 EYE STREET, NW
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City | WASHINGTON
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State | DC
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Zip | 20037
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Country | US
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Telephone | 202-994-3893
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 WISSAHICKON AVE APARTMENT M808A
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City | PHILADELPHIA
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State | PA
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Zip | 19144-5653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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