Individual
CHERYL BRACKBILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
228 BILLERICA RD, CHELMSFORD, MA 01824-3604
(978) 250-6200
(978) 244-6665
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPT, 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
21
MA
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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