Individual
SIDNEY BORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2132 GAUSE BLVD E, STE 6, SLIDELL, LA 70461-4243
(985) 646-2531
Mailing address
1190 WAGUESPACK ST, VACHERIE, LA 70090-5300
(504) 818-1173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05171
LICENSE #
LA
Enumeration date
08/23/2006
Last updated
07/08/2007
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