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Individual

LISA RACHELLE TORRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8 MEDICAL CENTER RD, EDGEWOOD, NM 87015-7086
(505) 281-3406
Mailing address
8 MEDICAL CENTER RD, EDGEWOOD, NM 87015-7086
(505) 281-3406

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
134524022
NM
363AM0700X
Medical Physician Assistant
Primary
PA2014-0076
NM

Other

Enumeration date
10/24/2014
Last updated
07/05/2023
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