Provider Demographics
NPI:1326683988
Name:BOROWSKI, MATTHEW DAVIS (ATC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DAVIS
Last Name:BOROWSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24816 COUNTRY OAK LOOP
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-7502
Mailing Address - Country:US
Mailing Address - Phone:480-645-3005
Mailing Address - Fax:
Practice Address - Street 1:111 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2741
Practice Address - Country:US
Practice Address - Phone:218-739-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0092742255A2300X
MN28632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer