# GREAT RIVER ORTHOPEDIC AND SPORTS MEDICINE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982224556
- **Authorized official:** JEFFREY F TRAINA MD (OWNER)
- **Authorized official phone:** (337) 404-4075

## Contact information

- **Practice address:** 376 COCOVILLE RD, MANSURA, LA 71350-4264
- **Practice address phone:** (337) 404-4075
- **Practice address fax:** (337) 404-4069
- **Mailing address:** 800 S 3RD ST, LEESVILLE, LA 71446-4750
- **Mailing address phone:** (423) 337-4075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2020
- **Last updated:** 04/23/2020