Provider Demographics
NPI:1669554069
Name:TORRES, GRETCHEN T (PT)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:T
Last Name:TORRES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:T
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2592 N GREGG AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5543
Mailing Address - Country:US
Mailing Address - Phone:479-444-9449
Mailing Address - Fax:479-444-9403
Practice Address - Street 1:2592 N GREGG AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5543
Practice Address - Country:US
Practice Address - Phone:479-444-9449
Practice Address - Fax:479-444-9403
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist