Individual
DEREK PAUL BORNHORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2203 MARCHBANKS AVE, ANDERSON, SC 29621-2247
(937) 726-7324
Mailing address
2203 MARCHBANKS AVE, ANDERSON, SC 29621-2247
(937) 726-7324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11102
SC
261QP2000X
Physical Therapy Clinic/Center
007331
KY
261QP2000X
Physical Therapy Clinic/Center
PT016629
OH
Other
Enumeration date
02/20/2019
Last updated
01/03/2024
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