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1073204665
ETHAN ALEKSANDR BORK
DEARBORN, MI
NPI
1073204665
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: MI 5151016273APP23)
Enumeration Date
2023-05-16
Last Update Date
2023-05-16
Business Address
-- ETHAN ALEKSANDR BORK DO
18101 OAKWOOD BLVD
DEARBORN, MI 48124-4089
Phone number: 313-593-7000
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Mailing Address
-- ETHAN ALEKSANDR BORK DO
15039 HARRISON AVE
ALLEN PARK, MI 48101-1806
Phone number: 313-613-9233
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