Individual
MRS. TESSA MARIE TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 N MAIN AVE, LOVINGTON, NM 88260-2830
(575) 396-6611
(575) 396-1454
Mailing address
1600 N MAIN AVE, LOVINGTON, NM 88260-2830
(575) 396-6611
(575) 396-1454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2009-0022
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71032380
—
NM
Enumeration date
09/17/2009
Last updated
05/19/2017
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