MEDICARE: TRIUMPH THERAPY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	7279	NC

General Provider Information

NPI Number	:	1033597745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUMPH THERAPY SERVICES

Provider Business Mailing Address
First Line	:	2427 MEDWAY DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27608-1612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2427 MEDWAY DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27608-1612
Country	:	US
Telephone Number	:	919-647-4763
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST/OWNER
Name	:	STEPHANIE N HALL
Credential	:	M.S., OTR/L
Telephone Number	:	919-647-4763

Provider Enumeration Date	:	05/13/2015
Last Update Date	:	05/26/2015

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Directions to “TRIUMPH THERAPY SERVICES ” Practice Location

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