Provider Demographics
NPI:1003294182
Name:TRIHEALTH PHYSICIANS OF INDIANA INC
Entity Type:Organization
Organization Name:TRIHEALTH PHYSICIANS OF INDIANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP CORP COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6302
Mailing Address - Street 1:10058 COOLEY RD # 6
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47012-9509
Mailing Address - Country:US
Mailing Address - Phone:765-647-0808
Mailing Address - Fax:765-647-2728
Practice Address - Street 1:10058 COOLEY RD # 6
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-9509
Practice Address - Country:US
Practice Address - Phone:765-647-0808
Practice Address - Fax:765-647-2728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy