| NPI | 1669146536 |
|---|---|
| Doing Business As | TRI STATE PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | WANTZY COOPER President 928-248-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2024-03-04 |