Organization
TRI-STATE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLAN W. ZASTROW (CEO)
(319) 524-7150
Entity
Organization
Contact information
Practice address
1603 MORGAN ST, SUITE 7, KEOKUK, IA 52632-3433
(319) 524-5734
(319) 524-5758
Mailing address
400 N 17TH ST, KEOKUK, IA 52632-3452
(319) 524-5734
(319) 524-5758
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25523
IA
Other
Enumeration date
11/02/2006
Last updated
06/17/2008
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