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NPI Code Detail

MEDICARE: JEFFREY BORJA

MEDICARE: JEFFREY BORJA
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
1225100000XPhysical Therapist2120NV

General Provider Information

NPI Number : 1528229457
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY BORJA
Provider Business Mailing Address
First Line : 10401 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1151
Country : US
Telephone Number : 702-207-4205
Fax Number :
Provider Business Practice Location Address
First Line : 10401 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1151
Country : US
Telephone Number : 702-207-4205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2008
Last Update Date : 06/23/2008

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Directions to “ JEFFREY BORJA ” Practice Location

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