Individual
ALEX EDWARD BORON-MAGULICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12228 ITTA BENA ROAD, EMORY, VA 24327
(276) 944-6928
Mailing address
PO BOX 947, EMORY, VA 24327-0947
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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