Provider Demographics
NPI:1275936122
Name:TORRES, CHRISTINE (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:DELOZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 WHITE SPRUCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1608
Mailing Address - Country:US
Mailing Address - Phone:585-489-9070
Mailing Address - Fax:
Practice Address - Street 1:428 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1608
Practice Address - Country:US
Practice Address - Phone:585-489-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25005413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist