Healthcare Provider Details

I. General information

NPI: 1427284272
Provider Name (Legal Business Name): IRENE M BOYD DBA/TRI-COUNTY ORTHOTIC PROSTHETIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 NW 23RD AVE
CHIEFLAND FL
32626-1976
US

IV. Provider business mailing address

1411 NW 23RD AVE
CHIEFLAND FL
32626-1976
US

V. Phone/Fax

Practice location:
  • Phone: 352-493-0360
  • Fax: 352-493-0369
Mailing address:
  • Phone: 352-493-0360
  • Fax: 352-493-0369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: IRENE M. BOYD
Title or Position: OWNER
Credential:
Phone: 352-493-0360