1285100735 NPI number — TORREY GAMMILL MSCCCSLP

Table of content: TORREY GAMMILL MSCCCSLP (NPI 1285100735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285100735 NPI number — TORREY GAMMILL MSCCCSLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAMMILL
Provider First Name:
TORREY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSCCCSLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285100735
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
C/O AAC SPECIALISTS LLC
Provider Second Line Business Mailing Address:
1885 CHERRYVILLE ROAD
Provider Business Mailing Address City Name:
GREENWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80121-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-204-5188
Provider Business Mailing Address Fax Number:
303-761-9491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
C/O AAC SPECIALISTS LLC
Provider Second Line Business Practice Location Address:
1885 CHERRYVILLE ROAD
Provider Business Practice Location Address City Name:
GREENWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80121-1504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-204-5188
Provider Business Practice Location Address Fax Number:
303-761-9491
Provider Enumeration Date:
10/22/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  14407919 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)