TRISTATE MEDICAL SPECIALISTS LLC

LAKE HAVASU CITY, AZ
NPI1356706774
Doing Business AsTRISTATE PAIN INSTITUTE
Entity TypeOrganization
Authorized ContactJOANN VENGER
Owner/Member Manager
928-788-3333
Organization Subpart ?No
Primary Taxonomy208VP0000X Pain Medicine, Pain Medicine
Additional Taxonomies207LP2900X Anesthesiology, Pain Medicine
207T00000X Neurological Surgery
(Licence: AZ  20605)
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine
208VP0000X Pain Medicine, Pain Medicine
(Licence: AZ  20605)
208VP0014X Pain Medicine, Interventional Pain Medicine
363L00000X Nurse Practitioner
(Licence: AZ  AP3760)
Enumeration Date2015-12-30
Last Update Date2022-07-19
Business Address
TRISTATE MEDICAL SPECIALISTS LLC
1987 MCCULLOCH BLVD N
LAKE HAVASU CITY, AZ 86403-5682
Phone number: 928-788-3333
Mailing Address
TRISTATE MEDICAL SPECIALISTS LLC
PO BOX 10966
FORT MOHAVE, AZ 86427-0966
Phone number: 928-788-3333