Individual
DERRICK RICHARD TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
80 SOUTH PRESCOTT STREET, MOMENTUM PHYSICAL REHABILITATION, LLC, MEMPHIS, TN 38111-4635
(901) 257-3422
(901) 257-3423
Mailing address
80 SOUTH PRESCOTT STREET, MOMENTUM PHYSICAL REHABILITATION, LLC, MEMPHIS, TN 38111-4635
(901) 257-3422
(901) 257-3423
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000005981
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446657
—
TN
01
—
4004523
BCBST
TN
Enumeration date
07/16/2015
Last updated
07/16/2015
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