Individual
MRS. CARA CHADBOURNE VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
489 BERNARDSTON RD, SUITE 108, GREENFIELD, MA 01301-1238
(413) 325-8500
(413) 772-6866
Mailing address
489 BERNARDSTON RD, SUITE 108, GREENFIELD, MA 01301-1238
(413) 325-8500
(413) 772-6866
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 3816
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA3816
MASSACHUSETTS STATE LICENSE
MA
Enumeration date
09/04/2009
Last updated
04/17/2013
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