| NPI | 1063503738 |
|---|---|
| Doing Business As | TRI STATE OTOLARYRGOLOGY INC |
| Entity Type | Organization |
| Authorized Contact | PHILLIP R STEVENS President 304-522-6388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 15360) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WV 19499) |
| 207Y00000X Otolaryngology (Licence: WV 18975) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-09-24 |