Provider Demographics
NPI:1700974755
Name:TORRES, JAZMIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAZMIN
Middle Name:
Last Name: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 1:4909 E CHANDLER BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0863
Mailing Address - Country:US
Mailing Address - Phone:480-940-7444
Mailing Address - Fax:480-940-7454
Practice Address - Street 1:4909 E CHANDLER BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0863
Practice Address - Country:US
Practice Address - Phone:480-940-7444
Practice Address - Fax:480-940-7454
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ65496Medicare ID - Type UnspecifiedGROUP
AZ65497Medicare ID - Type UnspecifiedINDIVIDUAL