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General NPI Number Information
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NPI Number | 1598283996
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Entity Type | Individual
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Provider Name | REBECC MOHL BORER ATC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 504 COLLEGE DR
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City | ALBANY
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State | GA
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Zip | 31705-2717
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Country | US
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Telephone | 229-886-2268
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Fax |
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Provider Business Mailing Address
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Address Line | 504 COLLEGE DR
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City | ALBANY
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State | GA
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Zip | 31705-2717
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Country | US
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Telephone | 229-430-1903
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Fax | 229-430-1774
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | AT001721
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License Number State | GA
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