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Individual

MR. BRIAN ALLEN BORCHARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
7119 MAPLE LN, HORACE, ND 58047-4714
(701) 281-1864
(701) 281-1924
Mailing address
7119 MAPLE LN, HORACE, ND 58047-4714
(701) 281-1864
(701) 281-1924

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1121
ND
2251P0200X
Pediatric Physical Therapist
6775
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23319
ND BLUE CROSS BLUE SHIELD
ND
05
51319
ND
01
64-05520
AETNA
01
821945
AMERICAS PPO
01
9075049
PRIVATE HEALTHCARE SYSTEM
01
HP50726
HEALTH PARTNERS
Enumeration date
01/03/2007
Last updated
07/08/2007
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