Tri-State Medical Specialists LLC
NPI #1023302643 in Fort Mohave, Arizona
Provider Information
- NPI Number
- 1023302643
- Entity Type
- Organization
- Organization Name
- Tri-State Medical Specialists LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- TRI-STATE MEDICAL SPECIALISTS LLC
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- May 31, 2011
- Last Updated
- Jul 19, 2022
Practice Location
- Address
- 1510 WAGON WHEEL LANE
- Address 2
- SUITE 110
- City
- Fort Mohave
- State
- Arizona
- ZIP Code
- 86426-6698
- Phone
- (928) 788-3333
Authorized Official
- Name
- JOANN VENGER
- Title
- OWNER
- Phone
- (928) 788-3333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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