Healthcare Provider Details

I. General information

NPI: 1508841628
Provider Name (Legal Business Name): TRIANGLE THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 06/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 TRAIL TWENTY THREE ST
DURHAM NC
27707-5156
US

IV. Provider business mailing address

3602 TRAIL TWENTY THREE ST
DURHAM NC
27707-5156
US

V. Phone/Fax

Practice location:
  • Phone: 919-489-7771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHEILA TAYROSE
Title or Position: PRESIDENT
Credential:
Phone: 919-489-7771