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Individual

MARY JOY BORTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
27477 HIGHWAY 64, SUITE C, CORNELL, WI 54732-5222
(715) 864-5394
(715) 239-0556
Mailing address
27477 HIGHWAY 64, SUITE C, CORNELL, WI 54732-5222
(715) 864-5394
(715) 239-0556

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10210
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40452000
WI
Enumeration date
03/09/2007
Last updated
04/19/2010
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