Organization
CARIBOU TRAIL PROFESSIONAL MEDICAL GROUP
Active
Organization
CARIBOU TRAIL PROFESSIONAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. BILLING (ADMINISTRATOR)
(509) 826-1760
Entity
Organization
Contact information
Practice address
520 W INDIAN AVE, BREWSTER, WA 98812-0220
(509) 826-1760
(509) 826-9927
Mailing address
PO BOX 220, 520 W INDIAN AVE, BREWSTER, WA 98812-0220
(509) 826-1760
(509) 826-9927
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OP00000831
WA
Other
Enumeration date
01/17/2008
Last updated
11/10/2014
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