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Individual

MR. MAXIMILIAN TORRES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4602 SW 53RD AVE, PORTLAND, OR 97221
(971) 533-4446
Mailing address
4602 SW 53RD AVE, PORTLAND, OR 97221
(971) 533-4446

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09670
OR
225200000X
Physical Therapy Assistant
P160856867
WA

Other

Enumeration date
09/22/2018
Last updated
09/22/2018
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