Individual
IAN THOMAS BORCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
714 BEL AIR DR W, VISTA, CA 92084-5526
(760) 809-4000
Mailing address
714 BEL AIR DR W, VISTA, CA 92084-5526
(760) 809-4000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
53143
CA
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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