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General NPI Number Information
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NPI Number | 1053483503
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Entity Type | Organization
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Legal Business Name | TRIA ORTHOPAEDIC CENTER LLC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 8100 NORTHLAND DRIVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55431
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Country | US
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Telephone | 952-831-8742
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Fax |
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Provider Business Mailing Address
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Address Line | 14700 28TH AVE N SUITE 20
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City | PLYMOUTH
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State | MN
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Zip | 55447
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Country | US
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Telephone | 763-559-3779
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Fax | 763-450-3986
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Authorized Official
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Title or Position | VP FINANCE
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Name | JASON J LUHRS
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Credential |
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Telephone | 952-883-7158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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