Healthcare Provider Details

I. General information

NPI: 1770082661
Provider Name (Legal Business Name): TRACY D ADAMS DBA TRINITY ORTHOTICS & PEDORTHICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 BOB WALLACE AVE SW STE B
HUNTSVILLE AL
35805-4166
US

IV. Provider business mailing address

2905 BOB WALLACE AVENUE SUITE B
HUNTSVILLE AL
35613-8134
US

V. Phone/Fax

Practice location:
  • Phone: 256-203-2565
  • Fax: 256-964-8134
Mailing address:
  • Phone: 256-203-2647
  • Fax: 256-964-8134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number8318
License Number StateAL

VIII. Authorized Official

Name: REBEKAH M ADAMS
Title or Position: BUSINESS MANAGER
Credential: C PED CFO
Phone: 256-203-2647