Provider Demographics
NPI:1366105439
Name:TORREZ, EZEKEAL
Entity type:Individual
Prefix:
First Name:EZEKEAL
Middle Name:
Last Name:TORREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6054 SUN MESA CIR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3459
Mailing Address - Country:US
Mailing Address - Phone:720-681-1123
Mailing Address - Fax:
Practice Address - Street 1:6054 SUN MESA CIR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-3459
Practice Address - Country:US
Practice Address - Phone:720-681-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer