Provider Demographics
NPI:1598283996
Name:BORER, REBECC MOHL (ATC)
Entity Type:Individual
Prefix:MRS
First Name:REBECC
Middle Name:MOHL
Last Name:BORER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31705-2717
Mailing Address - Country:US
Mailing Address - Phone:229-430-1903
Mailing Address - Fax:229-430-1774
Practice Address - Street 1:504 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-2717
Practice Address - Country:US
Practice Address - Phone:229-886-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0017212081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine