Provider Demographics
NPI:1043603483
Name:BORJA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:BORJA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:586-884-4565
Mailing Address - Street 1:44656 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1322
Mailing Address - Country:US
Mailing Address - Phone:586-884-4565
Mailing Address - Fax:888-996-2534
Practice Address - Street 1:44656 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1322
Practice Address - Country:US
Practice Address - Phone:586-884-4565
Practice Address - Fax:888-996-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016572261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy