Healthcare Provider Details

I. General information

NPI: 1720075302
Provider Name (Legal Business Name): CHRISTOPHER TORRES DPT, OCS, CEAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 COX RD
GASTONIA NC
28054-3453
US

IV. Provider business mailing address

1240 SHADOW BEND DR
TEGA CAY SC
29708-8460
US

V. Phone/Fax

Practice location:
  • Phone: 704-867-7455
  • Fax: 704-866-9492
Mailing address:
  • Phone: 317-445-0769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05006961A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11142
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number6969
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: