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Individual

NATHAN TYLER BORGET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAED, LAT, ATC, CSCS

Contact information

Practice address
6632 DIXIE RD, COLUMBUS, GA 31905-4218
(706) 545-1788
Mailing address
3609 14TH AVE, COLUMBUS, GA 31904-7840
(336) 707-6548

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003340
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AT003340
GEORGIA BOARD OF LICENSING
GA
Enumeration date
07/18/2018
Last updated
07/18/2018
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