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Individual

JONATHAN A BORCHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
222 MAIN ST, BLOOM, KS 67865-8511
(620) 885-4202
(620) 885-4805
Mailing address
PO BOX 127, MINNEOLA, KS 67865-0127
(620) 885-4202
(620) 885-4805

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500618
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100340770A
KS
05
100340770C
KS
Enumeration date
10/06/2006
Last updated
03/18/2014
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