Organization
TRI STATE IMMUNIZATION GROUP INC
Active
Other names
Passport Health of Evansville
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT R BURGESS (OWNER)
(812) 402-6000
Entity
Organization
Contact information
Practice address
101 PLAZA EAST BOULEVARD, STE 107, EVANSVILLE, IN 47715-2804
(812) 402-6000
(812) 402-6012
Mailing address
101 PLAZA EAST BLVD, STE 107, EVANSVILLE, IN 47715-2804
(812) 402-6000
(812) 402-6012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
06/28/2013
Last updated
06/29/2013
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