Provider Demographics
NPI:1508567132
Name:TORRES ROMAN, ISAMAR ZOE
Entity Type:Individual
Prefix:
First Name:ISAMAR
Middle Name:ZOE
Last Name:TORRES ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NC 54 APT D28
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6107
Mailing Address - Country:US
Mailing Address - Phone:787-636-9313
Mailing Address - Fax:
Practice Address - Street 1:202 W NC 54
Practice Address - Street 2:SUITE 103
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-408-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor