Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5910 | MN |
NPI | 1003086281 |
---|---|
Provider Name | Mrs. Jane Borner |
First Address | Hastings, MN 55033-8402 |
Second Address | Hastings, MN 55033-1056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |