Tri State Clinic, Inc.

NPI #1518083971 in Grundy, Virginia

Provider Information

NPI Number: 1518083971
Entity Type: Organization
Organization Name: Tri State Clinic, Inc.
Primary Specialty: Internal Medicine
Enumeration Date: Mar 21, 2007
Last Updated: Jan 9, 2015

Practice Location

Address: 1520 SLATE CREEK RD
City: Grundy
State: Virginia
ZIP Code: 24614-6975
Phone: (276) 935-6055

Authorized Official

Name: MRS. JANET STACY
Title: MANAGER
Phone: (276) 935-6055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Physician Assistant	363A00000X
Internal Medicine	207R00000X	Primary

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