Provider Demographics
NPI:1871367995
Name:WILLIAMS, TORREAN ALEXANDER SR (LMT ; CMMT)
Entity type:Individual
Prefix:
First Name:TORREAN
Middle Name:ALEXANDER
Last Name:WILLIAMS
Suffix:SR
Gender:M
Credentials:LMT ; CMMT
Other - Prefix:MR
Other - First Name:TANK
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT ; CMMT
Mailing Address - Street 1:1025 N 9TH ST STE 8
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5548
Mailing Address - Country:US
Mailing Address - Phone:318-582-0806
Mailing Address - Fax:
Practice Address - Street 1:1025 N 9TH ST STE 8
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5548
Practice Address - Country:US
Practice Address - Phone:318-582-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty