Provider Demographics
NPI:1285796391
Name:TOREN, JODY
Entity type:Individual
Prefix:MS
First Name:JODY
Middle Name:
Last Name:TOREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277-1517
Mailing Address - Country:US
Mailing Address - Phone:320-523-2875
Mailing Address - Fax:
Practice Address - Street 1:1804 TROTT AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-2743
Practice Address - Country:US
Practice Address - Phone:320-235-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other