# TRI-STATE RADIATION ONCOLOGY, INC.

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

## Provider details

- **NPI number:** 1518264829
- **Authorized official:** MS. BEVERLY JUNE RYDER (ADMINISTRATIVE DIRECTOR)
- **Authorized official phone:** (928) 763-3600

## Contact information

- **Practice address:** 2755 SILVER CREEK RD, SUITE 115, BULLHEAD CITY, AZ 86442-7904
- **Practice address phone:** (928) 763-3600
- **Practice address fax:** (928) 763-5700
- **Mailing address:** 2755 SILVER CREEK RD, SUITE 115, BULLHEAD CITY, AZ 86442-7904
- **Mailing address phone:** (928) 763-3600
- **Mailing address fax:** (928) 763-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0203X | Radiation Oncology Clinic/Center | 8-M-6352 | AZ | Yes |

## Other

- **Enumeration date:** 02/22/2011
- **Last updated:** 02/22/2011