MEDICARE: HF TRIAD LLC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1871831370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HF TRIAD LLC

Provider Business Mailing Address
First Line	:	4518 A WEST MARKET STREET
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1543
Country	:	US
Telephone Number	:	336-887-9460
Fax Number	:

Provider Business Practice Location Address
First Line	:	4518 A WEST MARKET STREET
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1543
Country	:	US
Telephone Number	:	336-887-9460
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROOSEVELT SMITH
Credential	:	DC
Telephone Number	:	336-235-4022

Provider Enumeration Date	:	01/18/2013
Last Update Date	:	01/02/2020

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Directions to “HF TRIAD LLC ” Practice Location

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