TRI-STATE TELEMED LLC

SOUTH POINT, OH
NPI1093180903
Entity TypeOrganization
Authorized ContactSHANNON MAXEY
Medical Director
304-208-5978
Organization Subpart ?No
Primary Taxonomy208D00000X General Practice
(Licence: KY  48537)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: KY  1121101)
Enumeration Date2015-12-02
Last Update Date2015-12-02
Business Address
TRI-STATE TELEMED LLC
178 PRIVATE ROAD 19423
SOUTH POINT, OH 45680-8831
Phone number: 304-208-5978
Mailing Address
TRI-STATE TELEMED LLC
620 PRIVATE ROAD 19423
SOUTH POINT, OH 45680-9019
Phone number: 304-208-5978