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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