Healthcare Provider Details

I. General information

NPI: 1841345592
Provider Name (Legal Business Name): RONALD C TORBETT P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BILOTTO DR.
CEDAR CREST NM
87008-0966
US

IV. Provider business mailing address

PO BOX 966 15 BILOTTO DR.
CEDAR CREST NM
87008-0966
US

V. Phone/Fax

Practice location:
  • Phone: 505-980-7856
  • Fax: 505-281-0867
Mailing address:
  • Phone: 505-980-7856
  • Fax: 505-281-0867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number196
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: