Individual
JACOB ANDREW BOROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428
(937) 268-6511
Mailing address
275 E 15TH AVE, COLUMBUS, OH 43201-1901
(419) 566-7391
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.006634
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
03/19/2018
Last updated
06/24/2018
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