Provider Demographics
NPI:1467532556
Name:TORRENCE, DANIEL BRUCE
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRUCE
Last Name:TORRENCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 SANDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-5451
Mailing Address - Country:US
Mailing Address - Phone:573-431-0223
Mailing Address - Fax:
Practice Address - Street 1:801 BRIM ST
Practice Address - Street 2:
Practice Address - City:DESLOGE
Practice Address - State:MO
Practice Address - Zip Code:63601-3441
Practice Address - Country:US
Practice Address - Phone:573-431-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999139204225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant