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General NPI Number Information
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NPI Number | 1336320720
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Entity Type | Organization
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Legal Business Name | TRI CONCEPTS, LLC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 154 BURNETTS DRIVE SUITE 103
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City | SUFFOLK
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State | VA
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Zip | 23434
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Country | US
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Telephone | 757-332-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 154 BURNETTS DRIVE SUITE 103
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City | SUFFOLK
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State | VA
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Zip | 23434
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Country | US
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Telephone | 757-332-9119
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DARLA BANKS
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Credential | MBR
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Telephone | 757-332-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | VA
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