Dylan Joseph Borruano, PTA
Individual provider Active NPI Physical Therapy Assistant · Addis, LA
NPI 1760155683 · NPPES record last updated Jul 27, 2021
Key facts
- NPI
- 1760155683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A10910 (LA)
- Practice address
- 3923 Cypress Hall Dr
Addis, LA 70710-3014 - Phone
- (000) 000-0000
- NPI assigned
- Jul 27, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A10910 | LA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A10910 | LA | Yes |
Addresses
Primary practice location
3923 Cypress Hall Dr
Addis, LA 70710-3014
Mailing address
3923 Cypress Hall Dr
Addis, LA 70710-3014
Other providers in Addis, LA
- Delilah A. Anderson-Martin
- Dajanae Arnaud
- Berthelot and Associates, LLC
- Jennifer Smith Berthelot
- Ashley Blanchard
- Ziyon Butler
- Santago Clark
- Kayce Domingue
- Rebecca Falcon
- Jeanne Fisher
All providers in Addis, LA · Physical Therapy Assistant in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.