Organization
TRIFECTA COMP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA MAE HAND PTA (PRESIDENT)
(740) 624-5701
Entity
Organization
Contact information
Practice address
331 GOOSEPOND ROAD, NEWARK, OH 43055-3184
(740) 366-0005
(740) 366-2407
Mailing address
403 SAND STREET, CROOKSVILLE, OH 43731-1230
(740) 624-5701
(740) 366-2407
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
OHPTA04698
OH
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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