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General NPI Number Information
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NPI Number | 1467894626
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Entity Type | Organization
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Legal Business Name | TRISTEN COMBS
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 208 WEST PL
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City | TRENTON
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State | OH
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Zip | 45067-1242
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Country | US
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Telephone | 513-255-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 208 WEST PL
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City | TRENTON
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State | OH
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Zip | 45067-1242
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Country | US
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Telephone | 513-255-2560
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | TRISTEN COMBS
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Credential |
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Telephone | 513-255-2560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | PN-139600-M-IV
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License Number State | OH
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