Tri State Medical Center Pllc
NPI #1073390944 in Belle Fourche, South Dakota
Provider Information
- NPI Number
- 1073390944
- Entity Type
- Organization
- Organization Name
- Tri State Medical Center Pllc
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Sep 13, 2023
- Last Updated
- Jan 11, 2024
Practice Location
- Address
- 2398 5TH AVE STE 101
- City
- Belle Fourche
- State
- South Dakota
- ZIP Code
- 57717-2340
- Phone
- (605) 645-2064
Authorized Official
- Name
- VANESSA KUDLOCK, CNP
- Title
- OWNER
- Phone
- (605) 568-0191
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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