Provider Demographics
NPI:1407900327
Name:TORRES, RIAN S (DC)
Entity Type:Individual
Prefix:DR
First Name:RIAN
Middle Name:S
Last Name:TORRES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ROOK
Other - Middle Name:S
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5983 W STATE ST STE C
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-3055
Mailing Address - Country:US
Mailing Address - Phone:208-854-0899
Mailing Address - Fax:208-854-0898
Practice Address - Street 1:5983 W STATE ST STE C
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-3055
Practice Address - Country:US
Practice Address - Phone:208-854-0899
Practice Address - Fax:208-854-0898
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1674891Medicare ID - Type Unspecified
IDU88446Medicare UPIN