Provider First Line Business Practice Location Address:
2596 INTERSTATE 55
Provider Second Line Business Practice Location Address:
TRISTATE ADVANCED SURGERY CENTER
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-559-2006
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2006