Provider Demographics
NPI:1285974642
Name:TORRES, JOHN NICK (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:NICK
Last Name:TORRES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 S BROOKHURST RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-3700
Mailing Address - Country:US
Mailing Address - Phone:714-879-9988
Mailing Address - Fax:714-879-1885
Practice Address - Street 1:1001 S BROOKHURST RD
Practice Address - Street 2:SUITE 101
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-3700
Practice Address - Country:US
Practice Address - Phone:714-879-9988
Practice Address - Fax:714-879-1885
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT34720225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist