Provider Demographics
NPI:1134991870
Name:BORKOSKI, BETHANY CLARK (DPT, PT)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:CLARK
Last Name:BORKOSKI
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 ARCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-8549
Mailing Address - Country:US
Mailing Address - Phone:803-645-6041
Mailing Address - Fax:
Practice Address - Street 1:5230 WOODSIDE EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-3816
Practice Address - Country:US
Practice Address - Phone:803-226-0058
Practice Address - Fax:980-444-0732
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist