Provider Demographics
NPI:1629312954
Name:TORRES, ALEXANDER (LAC)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 SAM RITTENBERG BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3362
Mailing Address - Country:US
Mailing Address - Phone:843-556-3462
Mailing Address - Fax:843-766-2103
Practice Address - Street 1:1124 SAM RITTENBERG BLVD STE 1
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3362
Practice Address - Country:US
Practice Address - Phone:843-556-3462
Practice Address - Fax:843-766-2103
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC159171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist