Most Relevant Information
Provider Data
| NPI Number: | 1003431750 |
| Provider Name: | JOANN BORUM |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2020 |
| Last Updated: | 06/12/2020 |
Provider Practice Location
15107 JENNINGS LN
BOWIE
MD
207217208
Practice Location Phone/Fax
| Phone: | 2025208259 |
| Fax: |
Provider Mailing Location
15107 JENNINGS LN
BOWIE
MD
207217208
Provider Mailing Phone/Fax
| Phone: | 2025208259 |
| Fax: |