Provider Demographics
NPI:1578933503
Name:T. TORRENCE BEAUTY, LLC
Entity Type:Organization
Organization Name:T. TORRENCE BEAUTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:313-319-3505
Mailing Address - Street 1:13731 VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1409
Mailing Address - Country:US
Mailing Address - Phone:313-319-3505
Mailing Address - Fax:248-542-0445
Practice Address - Street 1:13731 VICTORIA ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1409
Practice Address - Country:US
Practice Address - Phone:313-319-3505
Practice Address - Fax:248-542-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty