TRI-STATE MEDICAL SPECIALISTS LLC

FORT MOHAVE, AZ
NPI1649598426
Entity TypeOrganization
Authorized ContactKNAYA TABORA
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)
207T00000X Neurological Surgery
(Licence: NY  5573)
2081P2900X Physical Medicine & Rehabilitation Pain Medicine
208VP0000X Pain Medicine Pain Medicine
(Licence: AZ  20605)
208VP0000X Pain Medicine Pain Medicine
(Licence: NV  5573)
208VP0014X Pain Medicine Interventional Pain Medicine
363L00000X Nurse Practitioner
(Licence: AZ  AP8599)
363L00000X Nurse Practitioner
(Licence: AZ  AP3760)
363LF0000X Nurse Practitioner Family
(Licence: AZ  AP8599)
363LP2300X Nurse Practitioner Primary Care
(Licence: AZ  AP8599)
Enumeration Date2010-05-04
Last Update Date2023-10-12
Business Address
TRI-STATE MEDICAL SPECIALISTS LLC
1510 E WAGON WHEEL LN STE 110
FORT MOHAVE, AZ 86426-6698
Phone number: 928-788-3333
Mailing Address
TRI-STATE MEDICAL SPECIALISTS LLC
1510 E WAGON WHEEL LN STE 110
FORT MOHAVE, AZ 86426-6698
Phone number: 928-788-3333
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