Organization
TRISTATE ORTHOPAEDIC TREATMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE E HENDERSON MD (PRESIDENT)
(513) 791-6611
Entity
Organization
Contact information
Practice address
10547 MONTGOMERY RD, SUITE 400, CINCINNATI, OH 45242-4418
(513) 791-6611
(513) 791-6788
Mailing address
10547 MONTGOMERY RD, SUITE 400, CINCINNATI, OH 45242-4418
(513) 791-6611
(513) 791-6788
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0946007
—
OH
Enumeration date
09/12/2006
Last updated
02/19/2014
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