Organization
TRIAD ORTHOTICS AND PEDORTHICS INC.
Active
Other names
triad o&p
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ANDREW MANSFIELD C.O. C. PED. (OWNER)
(336) 712-4750
Entity
Organization
Contact information
Practice address
2419 LEWISVILLE CLEMMONS RD, SUITE 1, CLEMMONS, NC 27012-8976
(336) 712-4750
(336) 712-1056
Mailing address
2419 LEWISVILLE CLEMMONS RD, SUITE 1, CLEMMONS, NC 27012-8977
(336) 712-4750
(336) 712-1056
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010072336
—
VA
05
—
03093634
—
NY
01
—
045Y8
BCBS
NC
05
—
7703603
—
NC
01
—
7887369
AETNA
—
01
—
802694
PARTNER'S
—
05
—
DM1188
—
SC
Enumeration date
08/28/2006
Last updated
08/11/2017
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