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1154898344
JUSTIN ANTHONY BORMAN
GRAND RAPIDS, MI
NPI
1154898344
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MI 5502005756)
Enumeration Date
2018-10-26
Last Update Date
2021-06-17
Business Address
JUSTIN ANTHONY BORMAN PTA
5429 NORTHLAND DR NE STE A
GRAND RAPIDS, MI 49525-1089
Phone number: 616-855-0540
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Mailing Address
JUSTIN ANTHONY BORMAN PTA
2815 MOORE RD
BAILEY, MI 49303-9604
Phone number: 719-452-9952
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