Organization
TRISTATE ORTHOPAEDIC TREATMENT CENTER, INC.
Active
Other names
TOTC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE E HENDERSON JR. M.D. (PRESIDENT)
(513) 791-6611
Entity
Organization
Contact information
Practice address
10547 MONTGOMERY ROAD, SUITE 400, CINCINNATI, OH 45242-4418
(513) 791-6611
(513) 791-6788
Mailing address
10547 MONTGOMERY ROAD, SUITE 400, CINCINNATI, OH 45242-4418
(513) 791-6611
(513) 791-6788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2083X0100X
Occupational Medicine Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0946007
—
OH
05
—
200025270B
—
IN
05
—
200025270C
—
IN
05
—
200025270D
—
IN
Enumeration date
08/10/2006
Last updated
05/20/2014
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