Individual
MR. REYES TORRES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(770) 424-2024
Mailing address
3502 VALLEYHAVEN CT, SUWANEE, GA 30024-6439
(770) 424-6893
(770) 424-2024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003810
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889528440B
—
GA
05
—
889528440E
—
GA
05
—
889528440F
—
GA
Enumeration date
05/25/2006
Last updated
11/05/2019
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