Individual
MR. CLINTON BORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, MTC
Contact information
Practice address
7707 W DEER VALLEY RD, SUITE 100, PEORIA, AZ 85382-2101
(623) 376-9100
Mailing address
7707 W DEER VALLEY RD STE 100, SUITE 100, PEORIA, AZ 85382-2101
(623) 376-9100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5143
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
803660
—
AZ
Enumeration date
07/01/2005
Last updated
07/08/2007
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