NPI 1023302643
Tri-State Medical Specialists LLC
Practice location
- Address
- 1510 Wagon Wheel Lane Suite 110, Fort Mohave, AZ 86426-6698
- Phone
- (928) 788-3333
- Fax
- (928) 788-3555
- Mailing address
- PO Box 10966, Fort Mohave, AZ 86427-0966
Authorised official
- Name
- Joann Venger
- Title
- Owner
- Phone
- (928) 788-3333
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1023302643
- Entity type
- Organization
- NPI issued
- 31 May 2011
- Record last updated
- 19 Jul 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.