Organization
TRI STATE CLINIC, INC.
Active
Organization
TRI STATE CLINIC, INC.
Active
Other names
Tri State Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET STACY (MANAGER)
(276) 935-6055
Entity
Organization
Contact information
Practice address
1520 SLATE CREEK RD, GRUNDY, VA 24614-6975
(276) 935-6055
(276) 935-4430
Mailing address
1520 SLATE CREEK RD, GRUNDY, VA 24614-6975
(276) 935-6055
(276) 935-4430
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
0110004247
VA
Other
Enumeration date
03/21/2007
Last updated
01/09/2015
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