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Individual

MELLISSA BORST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
E2325 KING RD, WAUPACA, WI 54981-8270
(715) 258-4124
Mailing address
E2325 KING RD, WAUPACA, WI 54981-1698
(715) 258-4124

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17065-24
WI
225100000X
Physical Therapist
Primary
PTL.0018536
CO

Other

Enumeration date
09/02/2015
Last updated
05/08/2026
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