Basic Information
| Provider Information | |||||||||
| NPI: | 1629312954 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1124 SAM RITTENBERG BLVD STE 1 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294073362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435563462 | ||||||||
| FaxNumber: | 8437662103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1124 SAM RITTENBERG BLVD STE 1 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294073362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435563462 | ||||||||
| FaxNumber: | 8437662103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2012 | ||||||||
| LastUpdateDate: | 11/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | 159 | SC | Y | Other Service Providers | Acupuncturist |
No ID Information.