Provider Demographics
NPI:1679280903
Name:IZQUIERDO-TORRES, ANA (DC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:IZQUIERDO-TORRES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 CYPRESS PT
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-0076
Mailing Address - Country:US
Mailing Address - Phone:787-638-1139
Mailing Address - Fax:
Practice Address - Street 1:2728 W MALLARD CREEK CHURCH RD STE 330
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2309
Practice Address - Country:US
Practice Address - Phone:980-585-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor