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General NPI Number Information
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NPI Number | 1609409812
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Entity Type | Individual
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Provider Name | MARY EVE ADELINE TORRES ESCOTO PT
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Gender | Female
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Dates
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Enumeration Date | 02/16/2020
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 10605 BALBOA BLVD STE 330
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City | GRANADA HILLS
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State | CA
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Zip | 91344-6358
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Country | US
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Telephone | 818-832-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 8309 NORWOOD DR
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1511
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Country | US
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Telephone | 267-887-8585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 305073
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License Number State | CA
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