Provider Demographics
NPI:1558951947
Name:BORRERO, JULIO GABRIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:GABRIEL
Last Name:BORRERO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N 16TH ST APT 3061
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3815
Mailing Address - Country:US
Mailing Address - Phone:404-936-9847
Mailing Address - Fax:
Practice Address - Street 1:6705 N BLACK CANYON HWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1029
Practice Address - Country:US
Practice Address - Phone:480-442-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010488111N00000X
AZ9237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor