# TRISTAR HEALTH CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508632605
- **Authorized official:** MICHAEL NELSON (MANAGER)
- **Authorized official phone:** (508) 314-9896

## Contact information

- **Practice address:** 95 VERNON ST STE 203, WORCESTER, MA 01610-1989
- **Practice address phone:** (508) 373-2041
- **Mailing address:** 95 VERNON ST STE 203, WORCESTER, MA 01610-1989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 11/29/2023
- **Last updated:** 11/29/2023