Provider Demographics
NPI:1952449381
Name:TORRENCE, ANISTASIA LEANNE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANISTASIA
Middle Name:LEANNE
Last Name:TORRENCE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9297 HARE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-3770
Mailing Address - Country:US
Mailing Address - Phone:513-759-0055
Mailing Address - Fax:
Practice Address - Street 1:10653 TECHWOOD CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2833
Practice Address - Country:US
Practice Address - Phone:513-956-3200
Practice Address - Fax:513-956-3202
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8206225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist