Healthcare Provider Details

I. General information

NPI: 1568567808
Provider Name (Legal Business Name): TRISTATE ORTHOPAEDIC TREATMENT CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 N HIGH ST
HILLSBORO OH
45133-8273
US

IV. Provider business mailing address

10547 MONTGOMERY RD SUITE 400
CINCINNATI OH
45242-4418
US

V. Phone/Fax

Practice location:
  • Phone: 937-393-6169
  • Fax:
Mailing address:
  • Phone: 513-791-6611
  • Fax: 513-791-6788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateOH

VIII. Authorized Official

Name: EDMUND H. SCHWEITZER JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 513-791-6611