Organization
TRIAD LYMPHATICS LLC
Active
Organization
TRIAD LYMPHATICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAYDESHA BANKS OT, CLT (OWNER, CERTIFIED LYMPHEDEMA THERAPI)
(252) 529-8919
Entity
Organization
Contact information
Practice address
5486 ALAMO DR, WINSTON SALEM, NC 27104-3442
(252) 529-8919
Mailing address
6255 TOWNCENTER DR STE 874, CLEMMONS, NC 27012-9376
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
03/03/2022
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