Provider Demographics
NPI:1154639474
Name:TRI THERAPY EAST INC
Entity Type:Organization
Organization Name:TRI THERAPY EAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:MEASAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:252-756-3099
Mailing Address - Street 1:115 REGENCY BLVD
Mailing Address - Street 2:B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4645
Mailing Address - Country:US
Mailing Address - Phone:252-756-3099
Mailing Address - Fax:252-756-0667
Practice Address - Street 1:115 REGENCY BLVD
Practice Address - Street 2:B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4645
Practice Address - Country:US
Practice Address - Phone:252-756-3099
Practice Address - Fax:252-756-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7200250Medicaid