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General NPI Number Information
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NPI Number | 1235227174
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Entity Type | Organization
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Legal Business Name | TRI HEALTH CLINIC INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 11275 EAST MISSISSIPPI AVENUE SUITE 2S2
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City | AURORA
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State | CO
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Zip | 80012-3263
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Country | US
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Telephone | 720-859-9105
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Fax | 720-859-9106
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Provider Business Mailing Address
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Address Line | 11275 EAST MISSISSIPPI AVENUE SUITE 2S2
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City | AURORA
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State | CO
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Zip | 80012-3263
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Country | US
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Telephone | 720-859-9105
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Fax | 720-859-9106
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHUNG JOON SEO
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Credential | DC
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Telephone | 720-859-9105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5193
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License Number State | CO
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