NPI | 1164483491 |
---|---|
Doing Business As | TRI-STATE MEDICAL GROUP INC |
Entity Type | Organization |
Authorized Contact | APRIL K SCHNEDLER Lead Billing Coordinator 319-768-5809 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
Enumeration Date | 2006-03-28 |
Last Update Date | 2012-01-11 |