Borah, Andrew S

Borah, Andrew S is an sole proprietor health care provider with primary practice located at 1764 Meadow Vale Dr , South Lake Tahoe CA 96150-4929. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Borah, Andrew S can be contacted via phone (802) 318-2717.

Contact Information

Primary practice address
1764 Meadow Vale Dr South Lake Tahoe CA 96150-4929
Phone: (802) 318-2717
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1407248081
LBN Legal business name Borah, Andrew S
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 19th, 2015
Last updated Feb 19th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407248081 NPPES
California Other 2000008263 BOC

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