Healthcare Provider Details

I. General information

NPI: 1902801913
Provider Name (Legal Business Name): TRINITY ORTHOTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NORTHLAND BLVD SUITE 231
CINCINNATI OH
45246-3600
US

IV. Provider business mailing address

230 NORTHLAND BLVD SUITE 231
CINCINNATI OH
45246-3600
US

V. Phone/Fax

Practice location:
  • Phone: 513-771-2603
  • Fax:
Mailing address:
  • Phone: 513-771-2603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5265100001
License Number StateOH

VIII. Authorized Official

Name: MRS. DONNA PAULINE MAHAN
Title or Position: PRESIDENT
Credential:
Phone: 513-771-2603