Provider Demographics
NPI:1871888008
Name:BOREL, ARMAND BENNETT (ATP)
Entity type:Individual
Prefix:
First Name:ARMAND
Middle Name:BENNETT
Last Name:BOREL
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 ALCO AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4238
Mailing Address - Country:US
Mailing Address - Phone:225-291-7002
Mailing Address - Fax:
Practice Address - Street 1:10632 ALCO AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4238
Practice Address - Country:US
Practice Address - Phone:225-291-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATP695247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other