Organization
TRI-STATE EECP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON H ROSS (MANAGER)
(304) 522-3773
Entity
Organization
Contact information
Practice address
2900 1ST AVE, HUNTINGTON, WV 25702-1241
(304) 522-3773
Mailing address
PO BOX 997, HUNTINGTON, WV 25713-0997
(304) 522-3773
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18236
WV
Other
Enumeration date
03/08/2008
Last updated
06/07/2008
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