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NPI Code Detail

MEDICARE: BRYAN D. BORSUM D.C.

MEDICARE: BRYAN D. BORSUM D.C.
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
1246ZS0410XSurgical Technologist

General Provider Information

NPI Number : 1063400281
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN D. BORSUM D.C.
Provider Business Mailing Address
First Line : 3 MARYLAND FARMS STE 200
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5780
Country : US
Telephone Number : 615-345-5400
Fax Number : 888-468-6603
Provider Business Practice Location Address
First Line : 3 MARYLAND FARMS STE 200
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5780
Country : US
Telephone Number : 615-345-5400
Fax Number : 888-468-6603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 02/28/2019

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