| NPI | 1518083971 |
|---|---|
| Doing Business As | TRI STATE RURAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | JANET STACY Manager 276-935-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant (Licence: VA 0110004247) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2015-01-09 |