Basic Information
| Provider Information | |||||||||
| NPI: | 1639580657 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRIHEALTH OS, LLC | ||||||||
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| OtherOrganizationName: | TRIHEALTH ORTHPAEDIC AND SPINE INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 637783 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452637783 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138534749 | ||||||||
| FaxNumber: | 5138534740 | ||||||||
| Practice Location | |||||||||
| Address1: | 7450 S MASON MONTGOMERY RD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | MASON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450407802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137916611 | ||||||||
| FaxNumber: | 5132214848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2014 | ||||||||
| LastUpdateDate: | 07/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | NIENABER | ||||||||
| AuthorizedOfficialFirstName: | DONNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VP CORP COUSEL | ||||||||
| AuthorizedOfficialTelephone: | 5135696062 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.