Individual
ROSA L BORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 S 5TH ST, VIENNA, GA 31092-1529
(478) 244-4351
Mailing address
607 S 5TH ST, VIENNA, GA 31092-1529
(478) 244-4351
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
051413705
GA
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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