Provider Demographics
NPI:1316394547
Name:TORRES, JOSE (RRT)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 LEONARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-3408
Mailing Address - Country:US
Mailing Address - Phone:573-855-7736
Mailing Address - Fax:
Practice Address - Street 1:1140 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-3408
Practice Address - Country:US
Practice Address - Phone:573-855-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035575227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered