Provider Demographics
NPI:1932411238
Name:TORRES, AMBER AUBERT (PA-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:AUBERT
Last Name:TORRES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 CAMPBELL HILL ST NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1390
Mailing Address - Country:US
Mailing Address - Phone:770-422-0444
Mailing Address - Fax:770-422-4412
Practice Address - Street 1:61 WHITCHER ST NE STE 3110
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1179
Practice Address - Country:US
Practice Address - Phone:770-422-2326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200355363A00000X
GA6170363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant