Provider Demographics
NPI:1033164967
Name:TORRES, JAZPER ETHAN (ND, DC)
Entity Type:Individual
Prefix:DR
First Name:JAZPER
Middle Name:ETHAN
Last Name:TORRES
Suffix:
Gender:M
Credentials:ND, DC
Other - Prefix:DR
Other - First Name:ETHAN
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND, DC
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-0652
Mailing Address - Country:US
Mailing Address - Phone:406-261-4095
Mailing Address - Fax:
Practice Address - Street 1:3171 US HIGHWAY 93 N
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1359
Practice Address - Country:US
Practice Address - Phone:406-756-7634
Practice Address - Fax:406-756-7643
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-5593111N00000X
WANT60463323175F00000X
MTAHC-NAT-LIC-1794175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111N00000XChiropractic ProvidersChiropractor