Provider Demographics
NPI:1316048630
Name:TORRECAMPO, ELJY JOHN SIANSON (RPT)
Entity type:Individual
Prefix:MR
First Name:ELJY JOHN
Middle Name:SIANSON
Last Name:TORRECAMPO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STONEWAY LN
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1819
Mailing Address - Country:US
Mailing Address - Phone:417-438-8509
Mailing Address - Fax:
Practice Address - Street 1:215 STONEWAY LN
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1819
Practice Address - Country:US
Practice Address - Phone:417-438-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006007055225100000X
PAPT018545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist